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General NPI Number Information
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NPI Number | 1164209870
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Entity Type | Individual
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Provider Name | HERNANDO JARIER MARIN ORTIZ MD
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Gender | Male
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Dates
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Enumeration Date | 09/14/2023
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Last Update Date | 09/24/2023
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Provider Practice Location Address
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Address Line | CARRETERA PR 726 CALLE JOSE C. VAZQUEZ KM 0.2
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City | AIBONITO
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State | PR
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Zip | 00705
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Country | US
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Telephone | 787-735-8001
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Fax |
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Provider Business Mailing Address
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Address Line | 8288 CALLE BALBINO TRINTA
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City | MAYAGUEZ
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State | PR
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Zip | 00680-1966
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Country | US
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Telephone | 787-322-8215
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 23509
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License Number State | PR
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