Provider Demographics
NPI:1710134259
Name:ORTIZ, NAYDIMAR ABREU (MA)
Entity Type:Individual
Prefix:
First Name:NAYDIMAR
Middle Name:ABREU
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 CALLE COSTA RICA APT 604
Mailing Address - Street 2:CONDOMINIO VENUS PLAZA B
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00917-2518
Mailing Address - Country:US
Mailing Address - Phone:787-758-7356
Mailing Address - Fax:
Practice Address - Street 1:130 CALLE COSTA RICA APT 604
Practice Address - Street 2:CONDOMINIO VENUS PLAZA B
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-2518
Practice Address - Country:US
Practice Address - Phone:787-758-7356
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3073103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist