Provider Demographics
NPI:1174262208
Name:ORTIZ RAMOS, DALYZBETH
Entity Type:Individual
Prefix:
First Name:DALYZBETH
Middle Name:
Last Name:ORTIZ RAMOS
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:HC 6 BOX 59070
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680-9533
Mailing Address - Country:US
Mailing Address - Phone:787-636-8216
Mailing Address - Fax:
Practice Address - Street 1:PR-2 KM 1.59 AVENIDA HOSTOS, EDIFICIO VILLA CAPITN II
Practice Address - Street 2:SUITE 202
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-832-5986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6533103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty