Healthcare Provider Details

I. General information

NPI: 1134084791
Provider Name (Legal Business Name): SHIRLEY ANN FELICIANO ORTEGA MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CENTRO COMERCIAL HUMACAO AVE FORT MARTELO
HUMACAO PR
00791
US

IV. Provider business mailing address

CENTRO COMERCIAL HUMACAO AVE FORT MARTELO
HUMACAO PR
00791
US

V. Phone/Fax

Practice location:
  • Phone: 787-285-3978
  • Fax:
Mailing address:
  • Phone: 787-285-3978
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number7794
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: