1083811905 NPI number — MRS. INES ORTIZ ORTIZ

Table of content: MRS. INES ORTIZ ORTIZ (NPI 1083811905)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083811905 NPI number — MRS. INES ORTIZ ORTIZ

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ORTIZ
Provider First Name:
INES
Provider Middle Name:
ORTIZ
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1083811905
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
HC15 BOX 16285 CALLE GUAYACAN
Provider Second Line Business Mailing Address:
BO.TEJAS SECTOR ASTURIANA
Provider Business Mailing Address City Name:
HUMACAO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00791
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-473-2335
Provider Business Mailing Address Fax Number:
787-745-0242

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
URB.EL VERDE #19
Provider Second Line Business Practice Location Address:
CALLE LUCERO
Provider Business Practice Location Address City Name:
CAGUAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00725
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-850-7641
Provider Business Practice Location Address Fax Number:
787-745-0242
Provider Enumeration Date:
07/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  1035 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1035 . This is a "TERAPISTA OCUPACIONAL" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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