Provider Demographics
NPI:1578169850
Name:ORTIZ MEDINA, PEDRO FRANCISCO
Entity Type:Individual
Prefix:
First Name:PEDRO
Middle Name:FRANCISCO
Last Name:ORTIZ MEDINA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 346
Mailing Address - Street 2:
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00954-0346
Mailing Address - Country:US
Mailing Address - Phone:787-237-1953
Mailing Address - Fax:
Practice Address - Street 1:CARR 824 KM 2.4 BARR GALATEO
Practice Address - Street 2:
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00954
Practice Address - Country:US
Practice Address - Phone:787-237-1953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program