Provider Demographics
NPI:1326037359
Name:ORTIZ RAMOS, JORGE L (MD)
Entity Type:Individual
Prefix:
First Name:JORGE
Middle Name:L
Last Name:ORTIZ RAMOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PMB 213
Mailing Address - Street 2:PO BOX 2400
Mailing Address - City:TOD BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00951
Mailing Address - Country:US
Mailing Address - Phone:787-251-2667
Mailing Address - Fax:787-251-1418
Practice Address - Street 1:CARR 863 KM 0.5
Practice Address - Street 2:BO PAJAROS CANDELARIO
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949
Practice Address - Country:US
Practice Address - Phone:787-251-2667
Practice Address - Fax:787-251-1418
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-21
Last Update Date:2010-12-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR10106208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
F18824Medicare UPIN