MEDICARE: DR. ANGEL L SENQUIZ ORTIZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	5367	PR
2	208D00000X	General Practice Physician	5367	PR

General Provider Information

NPI Number	:	1578678744
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANGEL L SENQUIZ ORTIZ MD

Provider Business Mailing Address
First Line	:	1565 CALLE RODANO
Second Line	:	EL PARAISO
City	:	SAN JUAN
State	:	PR
Zip	:	00926-2927
Country	:	US
Telephone Number	:	787-607-4192
Fax Number	:

Provider Business Practice Location Address
First Line	:	1565 CALLE RODANO
Second Line	:	EL PARAISO
City	:	SAN JUAN
State	:	PR
Zip	:	00926-2927
Country	:	US
Telephone Number	:	787-607-4192
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	12/28/2016

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