Provider Demographics
NPI:1609041615
Name:ORTIZ, TOMAS JOSE (RPT)
Entity Type:Individual
Prefix:MR
First Name:TOMAS
Middle Name:JOSE
Last Name:ORTIZ
Suffix:
Gender:M
Credentials:RPT
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 276
Mailing Address - Street 2:
Mailing Address - City:SAN LORENZO
Mailing Address - State:PR
Mailing Address - Zip Code:00754-0276
Mailing Address - Country:US
Mailing Address - Phone:787-914-1826
Mailing Address - Fax:787-491-0661
Practice Address - Street 1:BARRIO FLORIDA KM.12.7
Practice Address - Street 2:BARRIO FLORIDA KM.12.7
Practice Address - City:SAN LORENZO
Practice Address - State:PR
Practice Address - Zip Code:00754-0276
Practice Address - Country:US
Practice Address - Phone:787-914-1826
Practice Address - Fax:787-491-0661
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR894225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist