Provider Demographics
NPI:1619266178
Name:ORTIZ, CRISTINA ISABEL (MD)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:ISABEL
Last Name:ORTIZ
Suffix:
Gender:F
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:CONDOMINIO PLAYA AZUL II
Mailing Address - Street 2:APT 709
Mailing Address - City:LUQUILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00773-0000
Mailing Address - Country:US
Mailing Address - Phone:939-332-3040
Mailing Address - Fax:
Practice Address - Street 1:AVENIDA FONT MARTELO #300
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00792-0000
Practice Address - Country:US
Practice Address - Phone:787-852-0505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-05
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR20307208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice