Provider Demographics
NPI:1497335343
Name:ORTUNO, YVONNE ALICIA
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:ALICIA
Last Name:ORTUNO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5801 WEBER RD
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-3966
Mailing Address - Country:US
Mailing Address - Phone:361-854-8441
Mailing Address - Fax:866-728-7131
Practice Address - Street 1:5801 WEBER RD
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-3966
Practice Address - Country:US
Practice Address - Phone:361-854-8441
Practice Address - Fax:866-728-7131
Is Sole Proprietor?:No
Enumeration Date:2021-04-13
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX119233183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician