Provider Demographics
NPI:1548426067
Name:ORTIZ-BAEZ, FERNANDO (MD)
Entity Type:Individual
Prefix:
First Name:FERNANDO
Middle Name:
Last Name:ORTIZ-BAEZ
Suffix:
Gender:M
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:ESTANCIAS DEL GOLF CLUB
Mailing Address - Street 2:509 LUIS A. MORALES
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00730-0531
Mailing Address - Country:US
Mailing Address - Phone:787-242-5135
Mailing Address - Fax:
Practice Address - Street 1:509 CALLE LUIS A MORALES
Practice Address - Street 2:ESTANCIAS DEL GOLF CLUB
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00730-0531
Practice Address - Country:US
Practice Address - Phone:787-242-5135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18299207P00000X
FLME112091207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine