Provider Demographics
NPI:1124567060
Name:ORTIZ-ROSA, MINOSHKA (PHARMD)
Entity Type:Individual
Prefix:
First Name:MINOSHKA
Middle Name:
Last Name:ORTIZ-ROSA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:839 CALLE ANASCO APT 1902
Mailing Address - Street 2:PLAZA UNIVERSIDAD 2000
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00925-2475
Mailing Address - Country:US
Mailing Address - Phone:787-618-5830
Mailing Address - Fax:
Practice Address - Street 1:685 CALLE CESAR GONZALEZ
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3920
Practice Address - Country:US
Practice Address - Phone:787-294-1730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-13
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6455183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist