Healthcare Provider Details

I. General information

NPI: 1588576201
Provider Name (Legal Business Name): JEZIEL TORRES ORTIZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 149 KM 21 BO PESAS PARCELAS MARIA 7
CIALES PR
00638
US

IV. Provider business mailing address

PO BOX 1152
CIALES PR
00638-1152
US

V. Phone/Fax

Practice location:
  • Phone: 787-930-1032
  • Fax:
Mailing address:
  • Phone: 787-930-1032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number14350
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: