Healthcare Provider Details

I. General information

NPI: 1710024278
Provider Name (Legal Business Name): JOSE J ORDEIN MD.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 AVE PONCE DE LEON STOP 37.5
SAN JUAN PR
00917-5032
US

IV. Provider business mailing address

PO BOX 2674
BAYAMON PR
00960-2674
US

V. Phone/Fax

Practice location:
  • Phone: 787-758-2000
  • Fax: 787-771-7996
Mailing address:
  • Phone: 787-771-7999
  • Fax: 787-771-7996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number9135
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number9135
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number9135
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: