Provider Demographics
NPI:1164658720
Name:ORTIZ - LLAURADOR, JOSE F
Entity Type:Individual
Prefix:MR
First Name:JOSE
Middle Name:F
Last Name:ORTIZ - LLAURADOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JOSE
Other - Middle Name:F
Other - Last Name:ORTIZ - LLAURADOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:EMT
Mailing Address - Street 1:311 TOPACIO
Mailing Address - Street 2:URB. ALTURAS PENUELAS 2
Mailing Address - City:PENUELAS
Mailing Address - State:PR
Mailing Address - Zip Code:00624
Mailing Address - Country:US
Mailing Address - Phone:787-836-3358
Mailing Address - Fax:
Practice Address - Street 1:311 CALLE TOPACIO
Practice Address - Street 2:URB. ALTURAS PENUELAS 2
Practice Address - City:PENUELAS
Practice Address - State:PR
Practice Address - Zip Code:00624-2303
Practice Address - Country:US
Practice Address - Phone:787-836-3358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-09
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRTM-P1625146L00000X, 341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic