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General NPI Number Information
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NPI Number | 1891771697
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Entity Type | Individual
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Provider Name | DR. LEONARDO ORTIZ
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Gender | Male
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Dates
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Enumeration Date | 12/22/2005
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Last Update Date | 08/15/2014
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Provider Practice Location Address
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Address Line | 140 AVE LAS CUMBRES
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City | GUAYNABO
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State | PR
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Zip | 00969-5523
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Country | US
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Telephone | 787-720-5050
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Fax |
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Provider Business Mailing Address
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Address Line | 55 CALLE VEREDA URB. MONTE VERDE REAL
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City | SAN JUAN
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State | PR
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Zip | 00924
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Country | US
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Telephone | 787-600-1321
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 9582
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 9582
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License Number State | PR
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