Provider Demographics
NPI:1033584099
Name:ORTIZ CASTRO, IDALINA
Entity Type:Individual
Prefix:
First Name:IDALINA
Middle Name:
Last Name:ORTIZ CASTRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE LUZ ESTE Q-9
Mailing Address - Street 2:LEVITTOWN
Mailing Address - City:TOA BAJA
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00949
Mailing Address - Country:UM
Mailing Address - Phone:787-212-3180
Mailing Address - Fax:787-784-2170
Practice Address - Street 1:CALLE LUZ ESTE Q-9
Practice Address - Street 2:LEVITTOWN
Practice Address - City:TOA BAJA
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00949
Practice Address - Country:UM
Practice Address - Phone:787-212-3180
Practice Address - Fax:787-784-2170
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-02
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8906163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse