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General NPI Number Information
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NPI Number | 1174798052
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Entity Type | Individual
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Provider Name | CARMEN S ORTIZ LCDA
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Gender | Female
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Dates
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Enumeration Date | 04/23/2008
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Last Update Date | 04/23/2008
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Provider Practice Location Address
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Address Line | CARR 183 # KM7.7 BO. HATO
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City | SAN LORENZO
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State | PR
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Zip | 00754-4530
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Country | US
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Telephone | 787-249-5350
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Fax | 787-736-8838
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Provider Business Mailing Address
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Address Line | PO BOX 5005 PMB 23
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City | SAN LORENZO
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State | PR
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Zip | 00754-5005
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Country | US
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Telephone | 787-249-5350
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Fax | 787-736-8838
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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 | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 6387
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License Number State | PR
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