Healthcare Provider Details

I. General information

NPI: 1942050612
Provider Name (Legal Business Name): JONATHAN APONTE ORTIZ PSY D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2024
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HC 1 BOX 4200
NAGUABO PR
00718-9776
US

IV. Provider business mailing address

HC 1 BOX 4200
NAGUABO PR
00718-9776
US

V. Phone/Fax

Practice location:
  • Phone: 787-639-9399
  • Fax:
Mailing address:
  • Phone: 787-639-9399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number8635
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: