Provider Demographics
NPI:1437737707
Name:ORTIZ TORRES, IRIS CECILIA (MD)
Entity Type:Individual
Prefix:DR
First Name:IRIS
Middle Name:CECILIA
Last Name:ORTIZ TORRES
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:URB. SAN ANTONIO A12
Mailing Address - Street 2:CALLE 1
Mailing Address - City:COAMO
Mailing Address - State:PR
Mailing Address - Zip Code:00769
Mailing Address - Country:US
Mailing Address - Phone:787-925-5859
Mailing Address - Fax:787-290-4472
Practice Address - Street 1:2015 BLVD LUIS A FERRE STE 101
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-0798
Practice Address - Country:US
Practice Address - Phone:787-842-8945
Practice Address - Fax:787-290-4472
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-30
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22170208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR22170OtherLICENCE