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NPI Code Detail

MEDICARE: JOSE DAVID ORTIZ-ROSARIO M.D.

MEDICARE: JOSE DAVID ORTIZ-ROSARIO M.D.
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
1207RN0300XNephrology Physician18163PR

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1HP096AOTHERPRMEDICARE PTAN

General Provider Information

NPI Number : 1629221940
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSE DAVID ORTIZ-ROSARIO M.D.
Provider Business Mailing Address
First Line : A8 VIA HORIZONTE
Second Line : URB LA VISTA
City : SAN JUAN
State : PR
Zip : 00924-4461
Country : US
Telephone Number : 787-886-3254
Fax Number : 787-957-1555
Provider Business Practice Location Address
First Line : B1 CALLE 1 ALTOS FARMACIA MEDINA #2
Second Line : VILLAS DE LOIZA
City : CANOVANAS
State : PR
Zip : 00729-4116
Country : US
Telephone Number : 787-886-3254
Fax Number : 787-957-1555
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2008
Last Update Date : 11/17/2025

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Directions to “ JOSE DAVID ORTIZ-ROSARIO M.D.” Practice Location

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