1316975345 NPI number — JOSE M ORTIZ VELEZ M.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316975345 NPI number — JOSE M ORTIZ VELEZ M.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

ORTIZ VELEZ

Provider First Name:

JOSE

Provider Middle Name:

M

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

M.D.

Provider Gender Code:

M

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:

1316975345

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

03/07/2011

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

HACIENDA SAN JOSE , # 94 VIA MORENILLA

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

CAGUAS

Provider Business Mailing Address State Name:

PR

Provider Business Mailing Address Postal Code:

00727-3008

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

787-744-8370

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

T1-11 , CALLE 28

Provider Second Line Business Practice Location Address:

TURABO GARDENS

Provider Business Practice Location Address City Name:

CAGUAS

Provider Business Practice Location Address State Name:

PR

Provider Business Practice Location Address Postal Code:

00725-0000

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

787-744-8370

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

06/29/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207Q00000X , with the licence number:  11445 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: PE4818 . This is a "PALIC PROVIDER" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
• Identifier: 100767 . This is a "CRUZ AZUL DE PR" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
• Identifier: 212904 . This is a "PREFERRED HEALTH" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
• Identifier: 2995 . This is a "PREFERRED MEDICARE CHOICE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
• Identifier: 11511445 . This is a "GLOBAL HEALTH" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
• Identifier: 400317 . This is a "MEDICARE Y MUCHO MAS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
• Identifier: 9900521 . This is a "HUMANA HEALTH PLAN" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
• Identifier: A272 . This is a "FIRST MEDICAL" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
• Identifier: 9900521 . This is a "HUMANA INSURANCE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
• Identifier: 22572 . This is a "TRIPLE S" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".