Provider Demographics
NPI:1760466817
Name:ORTIZ, MARIA DE LOURDES (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:DE LOURDES
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:HACIENDA SAN JOSE
Mailing Address - Street 2:86 VIA MIRADERO
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727-3007
Mailing Address - Country:US
Mailing Address - Phone:787-745-0806
Mailing Address - Fax:787-745-0806
Practice Address - Street 1:500 AVENIDA DEGETAU
Practice Address - Street 2:HIMA PLAZA 1 SUITE 414
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-7307
Practice Address - Country:US
Practice Address - Phone:787-258-0614
Practice Address - Fax:787-961-4663
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-02
Last Update Date:2018-02-08
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Provider Licenses
StateLicense IDTaxonomies
PR13806207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1864OtherPREFERRED MEDICARE CHOICE
PR061783OtherCRUZ AZUL
PR1802431OtherACAA
PR4301-5 5034OtherPROSAMM
PR9910OtherINTERNATIONAL MEDICAL
PR1260OtherAMERICAN HEALTH
PR213042OtherPREFERRED HEALTH
PR12513806OtherGLOBAL HEALTH
PR20681OtherTRIPLE S
PR7920023OtherHUMANA HEALTH
PR7920023OtherHUMANA INSURANCE
PR600666OtherMEDICARE Y MUCHO MAS
PR7920023OtherHUMANA INSURANCE
PR4301-5 5034OtherPROSAMM