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General NPI Number Information
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NPI Number | 1760466817
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Entity Type | Individual
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Provider Name | MARIA DE LOURDES ORTIZ MD
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Gender | Female
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Dates
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Enumeration Date | 12/02/2005
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Last Update Date | 02/08/2018
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Provider Practice Location Address
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Address Line | 500 AVENIDA DEGETAU HIMA PLAZA 1 SUITE 414
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City | CAGUAS
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State | PR
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Zip | 00725-7307
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Country | US
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Telephone | 787-258-0614
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Fax | 787-961-4663
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Provider Business Mailing Address
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Address Line | HACIENDA SAN JOSE 86 VIA MIRADERO
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City | CAGUAS
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State | PR
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Zip | 00727-3007
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Country | US
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Telephone | 787-745-0806
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Fax | 787-745-0806
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 13806
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License Number State | PR
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