Provider Demographics
NPI:1003076415
Name:ORTIZ-CARDONA, JOSE R (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:R
Last Name:ORTIZ-CARDONA
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:PO BOX 29134
Mailing Address - Street 2:ANESTESIOLOGIA RCM
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00929-0134
Mailing Address - Country:US
Mailing Address - Phone:787-758-0640
Mailing Address - Fax:787-758-1327
Practice Address - Street 1:ANESTESIOLOGIA RCM
Practice Address - Street 2:SUITE 989 EDIF PRINCIPAL CIENCIAS MEDICAS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00936-5067
Practice Address - Country:US
Practice Address - Phone:787-758-0640
Practice Address - Fax:787-758-1327
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-10
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR17354207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PREH958AMedicare PIN