Provider Demographics
NPI:1770233884
Name:ORTIZ CARRO, VERONICA LIZA
Entity Type:Individual
Prefix:MISS
First Name:VERONICA
Middle Name:LIZA
Last Name:ORTIZ CARRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MEDICAL CENTER PLAZA
Mailing Address - Street 2:1051 CALLE 3SE APT 1006
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921
Mailing Address - Country:US
Mailing Address - Phone:787-586-1814
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF PUERTO RICO
Practice Address - Street 2:MEDICAL SCIENCE CAMPUS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00936-5067
Practice Address - Country:US
Practice Address - Phone:787-758-2525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program