=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194699009
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DENISE ORTIZ CONDE
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/02/2025
-----------------------------------------------------
Last Update Date | 10/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | CARRETERA 198 KM 20.6 BARRIO CEIBA NORTE
-----------------------------------------------------
City | LAS PIEDRAS
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00771
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-694-3700
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1031
-----------------------------------------------------
City | SAN LORENZO
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00754-1031
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-694-3700
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | 1025
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------