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NPI Code Detail

MEDICARE: JAQUELINE LOPEZ ORTIZ

MEDICARE: JAQUELINE LOPEZ ORTIZ
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
1225400000XRehabilitation PractitionerNV

General Provider Information

NPI Number : 1871283879
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAQUELINE LOPEZ ORTIZ
Provider Business Mailing Address
First Line : 3680 N RANCHO DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89130-3180
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6363 S PECOS RD STE 206
Second Line :
City : LAS VEGAS
State : NV
Zip : 89120-6293
Country : US
Telephone Number : 702-850-2691
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2023
Last Update Date : 03/10/2026

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Directions to “ JAQUELINE LOPEZ ORTIZ ” Practice Location

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