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General NPI Number Information
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NPI Number | 1083811905
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Entity Type | Individual
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Provider Name | MRS. INES ORTIZ ORTIZ
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Gender | Female
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Dates
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Enumeration Date | 07/03/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | URB.EL VERDE #19 CALLE LUCERO
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City | CAGUAS
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State | PR
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Zip | 00725
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Country | US
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Telephone | 787-850-7641
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Fax | 787-745-0242
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Provider Business Mailing Address
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Address Line | HC15 BOX 16285 CALLE GUAYACAN BO.TEJAS SECTOR ASTURIANA
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City | HUMACAO
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State | PR
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Zip | 00791
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Country | US
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Telephone | 787-473-2335
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Fax | 787-745-0242
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 1035
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License Number State | PR
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