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General NPI Number Information
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NPI Number | 1790465391
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Entity Type | Individual
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Provider Name | NICOLE DENNISE GARCIA ORTIZ
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Gender | Female
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Dates
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Enumeration Date | 07/19/2023
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Last Update Date | 07/19/2023
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Provider Practice Location Address
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Address Line | CARR 3 R908 KM5.6 BO MARIANA II
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City | HUMACAO
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State | PR
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Zip | 00791
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Country | US
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Telephone | 939-717-7994
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Fax |
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Provider Business Mailing Address
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Address Line | HC 1 BOX 17120
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City | HUMACAO
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State | PR
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Zip | 00791-9029
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Country | US
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Telephone | 939-717-7994
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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