Provider Demographics
NPI:1770508095
Name:ORTIZ-GOMEZ, CRISTINA MARIA (MD)
Entity Type:Individual
Prefix:DR
First Name:CRISTINA
Middle Name:MARIA
Last Name:ORTIZ-GOMEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CRISTINA
Other - Middle Name:
Other - Last Name:ORTIZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:265 CALLE DE SAN SEBASTIAN
Mailing Address - Street 2:APT.# 4
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00901-1200
Mailing Address - Country:US
Mailing Address - Phone:787-722-2201
Mailing Address - Fax:
Practice Address - Street 1:265 CALLE DE SAN SEBASTIAN
Practice Address - Street 2:APT.# 4
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00901-1200
Practice Address - Country:US
Practice Address - Phone:787-722-2201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15315207Q00000X
NY232992207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine