Provider Demographics
NPI:1043508237
Name:ORTEGA CORTES, ED JOEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ED
Middle Name:JOEL
Last Name:ORTEGA CORTES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 215
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-0215
Mailing Address - Country:US
Mailing Address - Phone:787-424-9004
Mailing Address - Fax:787-780-3236
Practice Address - Street 1:59 CALLE DON CHEMARY
Practice Address - Street 2:
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676-4153
Practice Address - Country:US
Practice Address - Phone:787-877-9680
Practice Address - Fax:787-877-9680
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-21
Last Update Date:2017-03-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR18276208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRFL981AMedicare PIN