Provider Demographics
NPI:1558965111
Name:ORTIZ BERMUDEZ, YAMIL JOSUE (DPT)
Entity Type:Individual
Prefix:
First Name:YAMIL
Middle Name:JOSUE
Last Name:ORTIZ BERMUDEZ
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PALACIOS REALEAS
Mailing Address - Street 2:CALLE RICARDI 121
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953
Mailing Address - Country:US
Mailing Address - Phone:787-381-7852
Mailing Address - Fax:
Practice Address - Street 1:PALACIOS REALEAS
Practice Address - Street 2:CALLE RICARDI 121
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00953
Practice Address - Country:US
Practice Address - Phone:787-381-7852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4592225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist