Provider Demographics
NPI:1508014622
Name:ORTA GONZALEZ, LURMAG Y (MD)
Entity Type:Individual
Prefix:DR
First Name:LURMAG
Middle Name:Y
Last Name:ORTA GONZALEZ
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:ROUTE 181
Mailing Address - Street 2:LAGO ALTO PLZ
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976
Mailing Address - Country:US
Mailing Address - Phone:787-305-5200
Mailing Address - Fax:787-305-5201
Practice Address - Street 1:PO BOX 1996
Practice Address - Street 2:
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00977-1996
Practice Address - Country:US
Practice Address - Phone:787-787-9481
Practice Address - Fax:787-787-9533
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17268207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology