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General NPI Number Information
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NPI Number | 1245379304
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Entity Type | Individual
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Provider Name | WANDA E ORTIZ MUNIZ MD
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Gender | Female
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 01/24/2018
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Provider Practice Location Address
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Address Line | A4 CALLE MARGINAL
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City | MANATI
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State | PR
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Zip | 00674-4903
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Country | US
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Telephone | 787-884-5368
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Fax | 787-884-0881
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Provider Business Mailing Address
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Address Line | PO BOX 1036
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City | MANATI
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State | PR
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Zip | 00674-1036
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Country | US
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Telephone | 787-884-5368
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Fax | 787-884-0881
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 8867
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License Number State | PR
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