Provider Demographics
NPI:1245764034
Name:ORTIZ BONILLA, LEONORA MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:LEONORA
Middle Name:MARIE
Last Name:ORTIZ BONILLA
Suffix:
Gender:F
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:HC 1 BOX 5799
Mailing Address - Street 2:
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705-9785
Mailing Address - Country:US
Mailing Address - Phone:787-240-8691
Mailing Address - Fax:
Practice Address - Street 1:ROAD 14 BO. RINCON SECTOR LOMAS
Practice Address - Street 2:HOSPITAL MENONITA CAYEY
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00737-2800
Practice Address - Country:US
Practice Address - Phone:787-535-1001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-18
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR23158208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice