Healthcare Provider Details

I. General information

NPI: 1669957528
Provider Name (Legal Business Name): DR. JOSE L. ORTEGA, HEMATOLOGY AND ONCOLOGY GROUP PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2018
Last Update Date: 12/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AE1101 LA VILLA GARDEN APT
GUAYNABO PR
00971
US

IV. Provider business mailing address

DR JOSE LUIS ORTEGA SANCHEZ 1353 AVENIDA LUIS VIGOREAUX PMB 178
GUAYNABO PR
00966
US

V. Phone/Fax

Practice location:
  • Phone: 787-722-9030
  • Fax: 787-722-9049
Mailing address:
  • Phone: 787-722-9030
  • Fax: 787-722-9049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARISOL CRUZ
Title or Position: MEDICAL BILLER
Credential:
Phone: 787-312-2985