Provider Demographics
NPI:1093991416
Name:NAZARIO ORTIZ, WENDY I (OPTOMETRA)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:I
Last Name:NAZARIO ORTIZ
Suffix:
Gender:F
Credentials:OPTOMETRA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 227
Mailing Address - Street 2:
Mailing Address - City:LAJAS
Mailing Address - State:PR
Mailing Address - Zip Code:00667
Mailing Address - Country:US
Mailing Address - Phone:787-899-1800
Mailing Address - Fax:787-899-1800
Practice Address - Street 1:CALLE JOSE M. TORO BASORA #4
Practice Address - Street 2:
Practice Address - City:LAJAS
Practice Address - State:PR
Practice Address - Zip Code:00667
Practice Address - Country:US
Practice Address - Phone:787-899-1800
Practice Address - Fax:787-899-1800
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-16
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR270152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist