Provider Demographics
NPI:1619917937
Name:ORTIZ, IDITH RITA (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:IDITH
Middle Name:RITA
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HEMATOLOGIA PEDIATRICA RCM
Mailing Address - Street 2:PO BOX 29134
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00929-0134
Mailing Address - Country:US
Mailing Address - Phone:787-754-7410
Mailing Address - Fax:
Practice Address - Street 1:CLINICA DE LA ESCUELA DE MEDICINA
Practice Address - Street 2:REPARTO METROPOLITANO SHOPPING, AVE. AMERICO MIRANDA
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00921
Practice Address - Country:US
Practice Address - Phone:787-777-3535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6438208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics