Provider Demographics
NPI:1679020192
Name:ORTIZ, NAREIDA ELISA (PHARM D)
Entity Type:Individual
Prefix:
First Name:NAREIDA
Middle Name:ELISA
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 2 BOX 5625
Mailing Address - Street 2:
Mailing Address - City:VILLALBA
Mailing Address - State:PR
Mailing Address - Zip Code:00766-9750
Mailing Address - Country:US
Mailing Address - Phone:787-677-4144
Mailing Address - Fax:
Practice Address - Street 1:800 CARRETERA 3
Practice Address - Street 2:ARROYO TOWN CENTER
Practice Address - City:ARROYO
Practice Address - State:PR
Practice Address - Zip Code:00714
Practice Address - Country:US
Practice Address - Phone:787-839-8505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6367183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist