Healthcare Provider Details

I. General information

NPI: 1184530321
Provider Name (Legal Business Name): IRIS JANICE ORTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HC 05 BOX 13383
JUANA DIAZ PR
00795-9519
US

IV. Provider business mailing address

CARR 149 INT. 557 KM 0.2 GAYABAL SECTOR PASO HONDO
JUANA DIAZ PR
00795-9519
US

V. Phone/Fax

Practice location:
  • Phone: 787-210-4750
  • Fax:
Mailing address:
  • Phone: 787-210-4750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number13518
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: