Basic Information
Provider Information
NPI: 1770547655
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ORTIZ
FirstName: ALBERTO
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: COLINAS DE PARKVILLE. CALLE ROBERTO ARANA #A-11
Address2:  
City: GUAYNABO
State: PR
PostalCode: 009694465
CountryCode: US
TelephoneNumber: 7872729635
FaxNumber:  
Practice Location
Address1: PISO 9. A-989
Address2: CENTRO MEDICO, RECINTO DE CIENCIAS MEDICAS
City: RIO PIEDRAS
State: PR
PostalCode: 00935
CountryCode: US
TelephoneNumber: 7877662844
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/17/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X5541PRY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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