=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386625879
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HECTOR LUIS ORTIZ MARTINEZ MD FAAP
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/10/2005
-----------------------------------------------------
Last Update Date | 09/07/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | EDIFICIO POST CENTER 60 N OFICINA 107
-----------------------------------------------------
City | MAYAGUEZ
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00680
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-832-2222
-----------------------------------------------------
Fax | 787-832-2252
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 3912
-----------------------------------------------------
City | MAYAGUEZ
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00681-3912
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-832-2222
-----------------------------------------------------
Fax | 787-832-2252
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | 8277
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------