Provider Demographics
NPI:1508002676
Name:ORTIZ, SHARYBEL
Entity Type:Individual
Prefix:
First Name:SHARYBEL
Middle Name:
Last Name:ORTIZ
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:PO BOX 1085
Mailing Address - Street 2:
Mailing Address - City:HORMIGUEROS
Mailing Address - State:PR
Mailing Address - Zip Code:00660-1085
Mailing Address - Country:US
Mailing Address - Phone:787-849-4173
Mailing Address - Fax:787-264-7171
Practice Address - Street 1:CENTRO PROFESIONAL BORINQUEN
Practice Address - Street 2:CARR 102
Practice Address - City:CABO ROJO
Practice Address - State:PR
Practice Address - Zip Code:00623
Practice Address - Country:US
Practice Address - Phone:787-851-1500
Practice Address - Fax:787-254-0230
Is Sole Proprietor?:No
Enumeration Date:2008-12-19
Last Update Date:2008-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7493183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician