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General NPI Number Information
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NPI Number | 1013201540
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Entity Type | Individual
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Provider Name | JUAN CARLOS ORTIZ-DIAZ RPH
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Gender | Male
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Dates
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Enumeration Date | 06/01/2011
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Last Update Date | 06/01/2011
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Provider Practice Location Address
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Address Line | WALGREENS 90 R BARCELO
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City | CIDRA
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State | PR
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Zip | 00739
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Country | US
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Telephone | 787-739-4351
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Fax | 787-739-4394
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Provider Business Mailing Address
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Address Line | WALGREENS 90 R BARCELO
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City | CIDRA
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State | PR
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Zip | 00739
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Country | US
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Telephone | 787-739-4351
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Fax | 787-739-4394
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 4139
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License Number State | PR
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