Provider Demographics
NPI:1467693739
Name:ALBINO ORTIZ, SYLVIA YANIRA (PSYD)
Entity Type:Individual
Prefix:MISS
First Name:SYLVIA
Middle Name:YANIRA
Last Name:ALBINO ORTIZ
Suffix:
Gender:F
Credentials:PSYD
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 247
Mailing Address - Street 2:
Mailing Address - City:COROZAL
Mailing Address - State:PR
Mailing Address - Zip Code:00783-0247
Mailing Address - Country:US
Mailing Address - Phone:787-754-9494
Mailing Address - Fax:787-756-9494
Practice Address - Street 1:1608 CALLE BORI STE 211
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927-6112
Practice Address - Country:US
Practice Address - Phone:787-754-9494
Practice Address - Fax:787-756-9494
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-17
Last Update Date:2018-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3183103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical