Provider Demographics
NPI:1154512671
Name:ORTIZ, IRIS M (PHARMACIST)
Entity Type:Individual
Prefix:MRS
First Name:IRIS
Middle Name:M
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:E5 CALLE DIAMELA
Mailing Address - Street 2:1585
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-3339
Mailing Address - Country:US
Mailing Address - Phone:787-880-0733
Mailing Address - Fax:
Practice Address - Street 1:E5 CALLE DIAMELA
Practice Address - Street 2:1585
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00613-1585
Practice Address - Country:US
Practice Address - Phone:787-880-0733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-08
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2696183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist