1730558974 NPI number — PROF. BRYAN O. ORTIZ SIERRA RN MSN PHD(S)

Table of content: PROF. BRYAN O. ORTIZ SIERRA RN MSN PHD(S) (NPI 1730558974)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730558974 NPI number — PROF. BRYAN O. ORTIZ SIERRA RN MSN PHD(S)

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ORTIZ SIERRA
Provider First Name:
BRYAN
Provider Middle Name:
O.
Provider Name Prefix Text:
PROF.
Provider Name Suffix Text:
Provider Credential Text:
RN MSN PHD(S)
Provider Gender Code:
M

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:
1730558974
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/08/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PASEO DR. JOSE CELSO BARBOSA
Provider Second Line Business Mailing Address:
UNIVERSITY OF PUERTO RICO, MEDICAL SCIENCES CAMPUS
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00921
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-758-2525
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10 CALLE CASIA
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00921-3200
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-641-7582
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/17/2015

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: 364SA2100X , with the licence number:  75484 , 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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