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General NPI Number Information
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NPI Number | 1245764034
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Entity Type | Individual
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Provider Name | LEONORA MARIE ORTIZ BONILLA MD
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Gender | Female
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Dates
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Enumeration Date | 04/18/2017
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Last Update Date | 04/07/2023
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Provider Practice Location Address
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Address Line | ROAD 14 BO. RINCON SECTOR LOMAS HOSPITAL MENONITA CAYEY
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City | CAYEY
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State | PR
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Zip | 00737-2800
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Country | US
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Telephone | 787-535-1001
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Fax |
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Provider Business Mailing Address
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Address Line | HC 1 BOX 5799
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City | AIBONITO
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State | PR
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Zip | 00705-9785
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Country | US
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Telephone | 787-240-8691
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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 | 23158
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License Number State | PR
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