Provider Demographics
NPI:1578703500
Name:ORTIZ, OMAYRA I
Entity Type:Individual
Prefix:MS
First Name:OMAYRA
Middle Name:I
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE MUNOZ RIVERA
Mailing Address - Street 2:24
Mailing Address - City:ADJUNTAS
Mailing Address - State:PR
Mailing Address - Zip Code:00601
Mailing Address - Country:US
Mailing Address - Phone:787-829-5395
Mailing Address - Fax:787-829-6644
Practice Address - Street 1:SKY OPTICAL OUTLET
Practice Address - Street 2:CALLE MUNOZ RIVERA
Practice Address - City:ADJUNTAS
Practice Address - State:PR
Practice Address - Zip Code:00601
Practice Address - Country:US
Practice Address - Phone:787-829-5395
Practice Address - Fax:787-829-6644
Is Sole Proprietor?:No
Enumeration Date:2009-03-04
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician