Provider Demographics
NPI:1659151603
Name:ORTIZ ESSENTIAL VITAMINS ENERGY INC
Entity Type:Organization
Organization Name:ORTIZ ESSENTIAL VITAMINS ENERGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ABIMAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ORTIZ AVILES
Authorized Official - Suffix:
Authorized Official - Credentials:BSN
Authorized Official - Phone:939-264-4522
Mailing Address - Street 1:RR 1 BOX 44808
Mailing Address - Street 2:
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685-6228
Mailing Address - Country:US
Mailing Address - Phone:939-264-4522
Mailing Address - Fax:
Practice Address - Street 1:CARR 125 KM 18 H 3 BO GUATEMALA
Practice Address - Street 2:
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685
Practice Address - Country:US
Practice Address - Phone:939-264-4522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORTIZ ESSENTIAL VITAMINS ENERGY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion TherapyGroup - Single Specialty