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General NPI Number Information
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NPI Number | 1659151603
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Entity Type | Organization
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Legal Business Name | ORTIZ ESSENTIAL VITAMINS ENERGY INC
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Dates
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Enumeration Date | 10/05/2023
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Last Update Date | 10/05/2023
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Provider Practice Location Address
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Address Line | CARR 125 KM 18 H 3 BO GUATEMALA
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City | SAN SEBASTIAN
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State | PR
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Zip | 00685
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Country | US
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Telephone | 939-264-4522
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Fax |
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Provider Business Mailing Address
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Address Line | RR 1 BOX 44808
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City | SAN SEBASTIAN
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State | PR
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Zip | 00685-6228
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Country | US
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Telephone | 939-264-4522
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ABIMAEL ORTIZ AVILES
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Credential | BSN
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Telephone | 939-264-4522
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WI0500X
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Taxonomy Name | Infusion Therapy Registered Nurse
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License Number |
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License Number State |
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