Doctor Name: | JAN CARLOS ORTIZ ROSARIO |
NPI Number: | 1386020709 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 32125R |
Business Practice Address: | 917 Ave Tito Castro Ponce, PR - 007164717 |
Business Phone Number: | 7878433031 |
Business Fax Number: | |
Mailing Address: | 917 Ave Tito Castro, PONCE |
State: | PR |
Postal Code: | 007164717 |
Phone Number: | 7878433031 |
Fax Number: | |
NPI Enumeration Date: | 08/07/2015 |
NPI Last Update Date: | 01/13/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 32125R |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |