Healthcare Provider Details

I. General information

NPI: 1013906007
Provider Name (Legal Business Name): JOSE L ORTIZ COLON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2005
Last Update Date: 05/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

JP REYES LOPEZ J-49 URB ATENAS
MANATI PR
00674
US

IV. Provider business mailing address

PO BOX 1020
MANATI PR
00674
US

V. Phone/Fax

Practice location:
  • Phone: 787-854-3249
  • Fax: 787-854-2613
Mailing address:
  • Phone: 787-854-3249
  • Fax: 787-854-2613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number10 185
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierE22701
Identifier TypeOTHER
Identifier State
Identifier IssuerASOMEDIC
# 2
Identifier160426
Identifier TypeOTHER
Identifier State
Identifier IssuerACAA
# 3
Identifier27745
Identifier TypeOTHER
Identifier State
Identifier IssuerASOCIACION MAESTRO
# 4
Identifier88519
Identifier TypeOTHER
Identifier StatePR
Identifier IssuerSSS
# 5
Identifier3920
Identifier TypeOTHER
Identifier State
Identifier IssuerAMERICAN HEALTH
# 6
Identifier8623
Identifier TypeOTHER
Identifier State
Identifier IssuerINTERNATIONAL MEDICAL CAR
# 7
Identifier60193
Identifier TypeOTHER
Identifier StatePR
Identifier IssuerCRUZ AZUL
# 8
Identifier8035
Identifier TypeOTHER
Identifier State
Identifier IssuerFMPR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: