Healthcare Provider Details

I. General information

NPI: 1376246033
Provider Name (Legal Business Name): ANGELICA ROCIO ORTIZ-ANDINO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2023
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CENTRO MEDICO DE PUERTO RICO PASEO JOSE CELSO BARBOSA
SAN JUAN PR
00935-0001
US

IV. Provider business mailing address

PO BOX 191696
SAN JUAN PR
00919-1696
US

V. Phone/Fax

Practice location:
  • Phone: 787-758-2525
  • Fax:
Mailing address:
  • Phone: 787-237-8940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number6682948
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: