Healthcare Provider Details

I. General information

NPI: 1932039930
Provider Name (Legal Business Name): LIZBETH M ORTIZ BURGOS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 CALLE SANTA CRUZ
BAYAMON PR
00961-7052
US

IV. Provider business mailing address

HC 4 BOX 5932
BARRANQUITAS PR
00794-9414
US

V. Phone/Fax

Practice location:
  • Phone: 787-620-4747
  • Fax: 787-620-1540
Mailing address:
  • Phone: 787-205-1563
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number17770-I
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: