Provider Demographics
NPI:1083670012
Name:ORTIZ - RODRIGUEZ, AURISTELA (AUDIOLOGIST)
Entity Type:Individual
Prefix:MISS
First Name:AURISTELA
Middle Name:
Last Name:ORTIZ - RODRIGUEZ
Suffix:
Gender:F
Credentials:AUDIOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 241
Mailing Address - Street 2:BO. QUEBRADILLAS CARR. 152 KM 7.7
Mailing Address - City:BARRANQUITAS
Mailing Address - State:PR
Mailing Address - Zip Code:00794-0241
Mailing Address - Country:US
Mailing Address - Phone:787-857-3599
Mailing Address - Fax:787-857-3599
Practice Address - Street 1:BO. QUEBRADILLAS CARR. 152 KM 7.7
Practice Address - Street 2:
Practice Address - City:BARRANQUITAS
Practice Address - State:PR
Practice Address - Zip Code:00794
Practice Address - Country:US
Practice Address - Phone:787-857-3599
Practice Address - Fax:787-857-3599
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR543174400000X, 231H00000X
231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRP-86342Medicare UPIN
PR84754Medicare ID - Type Unspecified