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General NPI Number Information
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NPI Number | 1457495053
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Entity Type | Organization
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Legal Business Name | LUIS R ORTIZ
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Dates
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Enumeration Date | 02/16/2007
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Last Update Date | 04/28/2014
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Provider Practice Location Address
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Address Line | 16 AVE BUENA VISTA
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City | MOROVIS
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State | PR
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Zip | 00687
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Country | US
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Telephone | 787-862-3525
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Fax | 787-862-1511
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Provider Business Mailing Address
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Address Line | 16 AVE BUENA VISTA
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City | MOROVIS
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State | PR
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Zip | 00687
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Country | US
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Telephone | 787-862-3525
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Fax | 787-862-1511
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Authorized Official
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Title or Position | OWNER
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Name | LUIS ORTIZ
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Credential |
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Telephone | 787-862-3525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 15F2580
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License Number State | PR
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