Provider Demographics
NPI:1528031184
Name:ORTIZ TORRES, MIRZA I (MD)
Entity Type:Individual
Prefix:DR
First Name:MIRZA
Middle Name:I
Last Name:ORTIZ TORRES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:410 CALLE MENDEZ VIGO
Mailing Address - Street 2:SUITE 208
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-4800
Mailing Address - Country:US
Mailing Address - Phone:787-796-6682
Mailing Address - Fax:787-796-6041
Practice Address - Street 1:410 CALLE MENDEZ VIGO
Practice Address - Street 2:SUITE 208
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646-4800
Practice Address - Country:US
Practice Address - Phone:787-796-6682
Practice Address - Fax:787-796-6041
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-13
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR12367208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics