Provider Demographics
NPI:1518366954
Name:DRA. JULIA ORTIZ RANGEL P.S.C
Entity Type:Organization
Organization Name:DRA. JULIA ORTIZ RANGEL P.S.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-843-3089
Mailing Address - Street 1:18 CALLE BERTOLY
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00730-3162
Mailing Address - Country:US
Mailing Address - Phone:787-843-3089
Mailing Address - Fax:787-843-3089
Practice Address - Street 1:18 CALLE BERTOLY
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00730
Practice Address - Country:US
Practice Address - Phone:787-843-3089
Practice Address - Fax:787-843-3089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-21
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR010094208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRID275AOtherFIRST COAST PTAN CORP
PRID276ZOtherFIRST COAST PTAN