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General NPI Number Information
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NPI Number | 1518466614
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Entity Type | Individual
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Provider Name | CRISTINA M ORTIZ MALAVE MD
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Gender | Female
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Dates
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Enumeration Date | 02/05/2018
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Last Update Date | 08/19/2024
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Provider Practice Location Address
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Address Line | 1701 W CHARLESTON BLVD STE 230
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City | LAS VEGAS
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State | NV
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Zip | 89102-2312
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Country | US
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Telephone | 702-671-2345
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Fax |
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Provider Business Mailing Address
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Address Line | 10 CALLE CASIA
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City | SAN JUAN
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State | PR
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Zip | 00921-3200
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Country | US
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Telephone |
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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 | 22662
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 25862
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License Number State | NV
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