Provider Demographics
NPI:1679554489
Name:ORTIZ, RAMON A
Entity Type:Individual
Prefix:MR
First Name:RAMON
Middle Name:A
Last Name:ORTIZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 CALLE COLON
Mailing Address - Street 2:
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602-3224
Mailing Address - Country:US
Mailing Address - Phone:787-868-2135
Mailing Address - Fax:787-868-2933
Practice Address - Street 1:228 CALLE COLON
Practice Address - Street 2:
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602-3224
Practice Address - Country:US
Practice Address - Phone:787-868-2135
Practice Address - Fax:787-868-2933
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3234183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist