Doctor Name: | ILIA YAHJAIRA ORTIZ-CASTRO |
NPI Number: | 1104082056 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 17195 |
Business Practice Address: | Hc 2 Box 15100 Rio Grande, PR - 007458900 |
Business Phone Number: | 7878884343 |
Business Fax Number: | |
Mailing Address: | Hc 2 Box 15100, RIO GRANDE |
State: | PR |
Postal Code: | 007458900 |
Phone Number: | 7878884343 |
Fax Number: | |
NPI Enumeration Date: | 07/30/2008 |
NPI Last Update Date: | 09/03/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 17195 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |