Provider Demographics
NPI:1083811905
Name:ORTIZ, INES ORTIZ
Entity Type:Individual
Prefix:MRS
First Name:INES
Middle Name:ORTIZ
Last Name:ORTIZ
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:HC15 BOX 16285 CALLE GUAYACAN
Mailing Address - Street 2:BO.TEJAS SECTOR ASTURIANA
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791
Mailing Address - Country:US
Mailing Address - Phone:787-473-2335
Mailing Address - Fax:787-745-0242
Practice Address - Street 1:URB.EL VERDE #19
Practice Address - Street 2:CALLE LUCERO
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-850-7641
Practice Address - Fax:787-745-0242
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1035174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1035OtherTERAPISTA OCUPACIONAL