MEDICARE: DR. JUAN CARLOS ORTIZ SANTIAGO 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	207R00000X	Internal Medicine Physician	16828	PR

General Provider Information

NPI Number	:	1942403084
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUAN CARLOS ORTIZ SANTIAGO MD

Provider Business Mailing Address
First Line	:	29 CALLE 2
Second Line	:	GARDEN HILLS ESTATES
City	:	GUAYNABO
State	:	PR
Zip	:	00966-2907
Country	:	US
Telephone Number	:	787-485-0419
Fax Number	:	787-961-0091

Provider Business Practice Location Address
First Line	:	CENTRO COMERCIAL LOS PRADOS
Second Line	:	SUITE E
City	:	CAGUAS
State	:	PR
Zip	:	00727-9507
Country	:	US
Telephone Number	:	787-961-0091
Fax Number	:	787-961-0045

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

Provider Enumeration Date	:	06/07/2007
Last Update Date	:	04/04/2023

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