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General NPI Number Information
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NPI Number | 1316284169
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Entity Type | Individual
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Provider Name | HERMES G. ROSARIO ORTIZ PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 01/14/2013
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Last Update Date | 04/02/2016
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Provider Practice Location Address
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Address Line | CARR. 417 KM 2.7 BO MALPASO EDIF. CARRIBEAN OFFICE PARK
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City | AGUADA
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State | PR
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Zip | 00602
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Country | US
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Telephone | 787-868-1828
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1635
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City | AGUADILLA
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State | PR
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Zip | 00605-1635
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Country | US
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Telephone | 787-244-1475
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 004639
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License Number State | PR
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