Provider Demographics
NPI:1760563092
Name:ORTIZ RIVERA, JOSEFINA (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEFINA
Middle Name:
Last Name:ORTIZ RIVERA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 6 BOX 14874
Mailing Address - Street 2:
Mailing Address - City:COROZAL
Mailing Address - State:PR
Mailing Address - Zip Code:00783-7800
Mailing Address - Country:US
Mailing Address - Phone:787-859-5308
Mailing Address - Fax:787-857-0800
Practice Address - Street 1:HC 06 BOX 14874
Practice Address - Street 2:
Practice Address - City:COROZAL
Practice Address - State:PR
Practice Address - Zip Code:00783-7800
Practice Address - Country:US
Practice Address - Phone:787-857-2413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15528208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR778575OtherHGP
PR400373OtherMMM
PR6606027293OtherMCS
PR101003OtherCRUL AZUL
PR21013OtherTRIPLE S
PR7940027OtherHUMANA
PR00351OtherMENONITA
PR400373OtherMMM
PR778575OtherHGP