Provider Demographics
NPI:1245565696
Name:LABOY-ORTIZ, IVAN ENRIQUE (MD)
Entity Type:Individual
Prefix:DR
First Name:IVAN
Middle Name:ENRIQUE
Last Name:LABOY-ORTIZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9341
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-9341
Mailing Address - Country:US
Mailing Address - Phone:787-510-0398
Mailing Address - Fax:939-337-5287
Practice Address - Street 1:AVE LAS AMERICAS BS4 BAIROA
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-5819
Practice Address - Country:US
Practice Address - Phone:787-746-7066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-02
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18331207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism