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General NPI Number Information
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NPI Number | 1033102710
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Entity Type | Individual
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Provider Name | VICTOR LUIS ORTIZ MD
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Gender | Male
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Dates
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Enumeration Date | 08/26/2005
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Last Update Date | 09/10/2024
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Provider Practice Location Address
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Address Line | 86 MDG, UNIT 3215 RAMSTEIN AB
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City | APO
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State | AE
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Zip | 09094
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Country | US
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Telephone | 316-480-3434
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Fax |
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Provider Business Mailing Address
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Address Line | PSC 2 BOX 6932
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City | APO
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State | AE
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Zip | 09012-0070
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Country | US
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Telephone |
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD2010-0550
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 12990
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License Number State | PR
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