1447363130 NPI number — DR. NIVIA ESTHER CRUZ-ORTIZ M.D.

Table of content: DR. NIVIA ESTHER CRUZ-ORTIZ M.D. (NPI 1447363130)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447363130 NPI number — DR. NIVIA ESTHER CRUZ-ORTIZ M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CRUZ-ORTIZ
Provider First Name:
NIVIA
Provider Middle Name:
ESTHER
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1447363130
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/21/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
RR #3 BOX 3875 19 CAMINO REAL
Provider Second Line Business Mailing Address:
BEVERLY HILLS
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00926-9613
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-396-5360
Provider Business Mailing Address Fax Number:
787-773-8041

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
COND. TORRE DE AUXLIO MUTUO OFIC. 712
Provider Second Line Business Practice Location Address:
735 PONCE DE LEON
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00917
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-773-8040
Provider Business Practice Location Address Fax Number:
787-773-8041
Provider Enumeration Date:
08/16/2006

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: 207RN0300X , with the licence number:  4705 , 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)





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