Healthcare Provider Details

I. General information

NPI: 1134413701
Provider Name (Legal Business Name): YAIZA MARTINEZ-ORTIZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2011
Last Update Date: 11/28/2023
Certification Date: 11/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 WASHINGTON STREET ASHFORD MEDICAL CENTER STE 601-602
SAN JUAN PR
00907
US

IV. Provider business mailing address

29 CALLE WASHINGTON STE 601-602
SAN JUAN PR
00907-1510
US

V. Phone/Fax

Practice location:
  • Phone: 787-249-9560
  • Fax: 509-275-5604
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number18688
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: