MEDICARE: DR. JOSE MARTIN 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
1	207RG0100X	Gastroenterology Physician	12265	PR

General Provider Information

NPI Number	:	1902802051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE MARTIN ORTIZ

Provider Business Mailing Address
First Line	:	10 CALLE CASIA
Second Line	:	VA CARIBBEAN HEALTHCARE SYSTEM
City	:	SAN JUAN
State	:	PR
Zip	:	00921-3200
Country	:	US
Telephone Number	:	787-641-7582
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 CALLE CASIA
Second Line	:	VA CARIBBEAN HEALTHCARE SYSTEM
City	:	SAN JUAN
State	:	PR
Zip	:	00921-3200
Country	:	US
Telephone Number	:	787-641-7582
Fax Number	:

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

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	02/28/2017

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