Provider Demographics
NPI:1518561315
Name:ORTIZ ALMANZAR, RONALD ISAAC (DOCTOR IN MEDICINE)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:ISAAC
Last Name:ORTIZ ALMANZAR
Suffix:
Gender:M
Credentials:DOCTOR IN MEDICINE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:REPARTO ANAMAR #14 DIGITALIS
Mailing Address - Street 2:
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949-5381
Mailing Address - Country:US
Mailing Address - Phone:787-234-2177
Mailing Address - Fax:
Practice Address - Street 1:REPARTO ANAMAR #14 DIGITALIS
Practice Address - Street 2:
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949-5381
Practice Address - Country:US
Practice Address - Phone:787-234-2177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-23
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PR22142208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program