Healthcare Provider Details

I. General information

NPI: 1841331733
Provider Name (Legal Business Name): VERONICA ORTIZ RODRIGUEZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: VERONICA ORTIZ RODRIGUEZ M.D.

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 06/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MIGRANT HEALTH CENTER, INC CARR 101 KM 7.1 BO PALMAREJO
LAJAS PR
00667
US

IV. Provider business mailing address

PO BOX 7128 MIGRANT HEALTH CENTER INC
MAYAGUEZ PR
00681-7128
US

V. Phone/Fax

Practice location:
  • Phone: 787-808-0897
  • Fax: 787-808-1420
Mailing address:
  • Phone: 787-805-2900
  • Fax: 787-834-1924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number11219
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: