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General NPI Number Information
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NPI Number | 1750585071
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Entity Type | Individual
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Provider Name | GLORIA E ORTIZ MARTINEZ PH.D
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Gender | Female
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Dates
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Enumeration Date | 06/12/2007
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Last Update Date | 03/06/2012
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Provider Practice Location Address
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Address Line | ST ESPINELA 20, AVE LUIS MUNOZ MARIN URB VILLA BLANCA
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City | CAGUAS
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State | PR
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Zip | 00726
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Country | US
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Telephone | 787-608-7484
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Fax | 787-286-0185
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Provider Business Mailing Address
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Address Line | PO BOX 3209
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City | CAGUAS
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State | PR
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Zip | 00726-3209
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Country | US
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Telephone | 787-286-0185
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Fax | 787-286-0185
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 1060
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License Number State | PR
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