Provider Demographics
NPI:1033278791
Name:ORTIZ CASTRO, NORBERTO (MD)
Entity Type:Individual
Prefix:
First Name:NORBERTO
Middle Name:
Last Name:ORTIZ CASTRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HCO 3 BOX 37764
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680
Mailing Address - Country:US
Mailing Address - Phone:787-827-1110
Mailing Address - Fax:787-827-1110
Practice Address - Street 1:82 AVE MATIAS BRUGMAN
Practice Address - Street 2:
Practice Address - City:LAS MARIAS
Practice Address - State:PR
Practice Address - Zip Code:00670-2015
Practice Address - Country:US
Practice Address - Phone:787-827-1110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13218207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H26580Medicare UPIN
PR20363Medicare ID - Type Unspecified