1083670012 NPI number — MISS AURISTELA ORTIZ - RODRIGUEZ AUDIOLOGIST

Table of content: MISS AURISTELA ORTIZ - RODRIGUEZ AUDIOLOGIST (NPI 1083670012)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083670012 NPI number — MISS AURISTELA ORTIZ - RODRIGUEZ AUDIOLOGIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ORTIZ - RODRIGUEZ
Provider First Name:
AURISTELA
Provider Middle Name:
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
AUDIOLOGIST
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:
1083670012
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/30/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 241
Provider Second Line Business Mailing Address:
BO. QUEBRADILLAS CARR. 152 KM 7.7
Provider Business Mailing Address City Name:
BARRANQUITAS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00794-0241
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-857-3599
Provider Business Mailing Address Fax Number:
787-857-3599

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
BO. QUEBRADILLAS CARR. 152 KM 7.7
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BARRANQUITAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00794
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-857-3599
Provider Business Practice Location Address Fax Number:
787-857-3599
Provider Enumeration Date:
04/26/2006

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:  543 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 231H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 231H00000X , with the licence number: 543 , 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)