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General NPI Number Information
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NPI Number | 1699009449
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Entity Type | Individual
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Provider Name | CARMEN AIDA DELVALLE ORTIZ M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/28/2009
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Last Update Date | 09/28/2009
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Provider Practice Location Address
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Address Line | 2700 MLK JR AVE SE
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City | WASHINGTON
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State | DC
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Zip | 20032
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Country | US
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Telephone | 703-899-8348
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Fax |
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Provider Business Mailing Address
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Address Line | 7304 HARTSHORNE SQ
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City | ALEXANDRIA
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State | VA
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Zip | 22315-3543
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD25150
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License Number State | DC
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