Provider Demographics
NPI:1063023653
Name:ORTIZ, NYLET ELIANY (DC)
Entity Type:Individual
Prefix:
First Name:NYLET
Middle Name:ELIANY
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BA6A CALLE 60
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-4678
Mailing Address - Country:US
Mailing Address - Phone:678-630-5187
Mailing Address - Fax:
Practice Address - Street 1:BA6A CALLE 60
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-4678
Practice Address - Country:US
Practice Address - Phone:678-630-5187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-16
Last Update Date:2020-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR723111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor