Provider Demographics
NPI:1023561792
Name:ORTIZ TORRES, MICHAEL JAVIER
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JAVIER
Last Name:ORTIZ TORRES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MM51 CALLE 30
Mailing Address - Street 2:URB. SANTA JUANITA
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956-4766
Mailing Address - Country:US
Mailing Address - Phone:787-457-0092
Mailing Address - Fax:
Practice Address - Street 1:MM51 CALLE 30
Practice Address - Street 2:URB. SANTA JUANITA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956-4766
Practice Address - Country:US
Practice Address - Phone:787-457-0092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-29
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program