Provider Demographics
NPI:1851501456
Name:ORTIZ SANTIAGO, JORGE E (SW)
Entity Type:Individual
Prefix:
First Name:JORGE
Middle Name:E
Last Name:ORTIZ SANTIAGO
Suffix:
Gender:M
Credentials:SW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PLAZA ITURREGUI
Mailing Address - Street 2:SUITE 217-A 65 INFANTERIA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-0000
Mailing Address - Country:US
Mailing Address - Phone:787-768-5501
Mailing Address - Fax:787-768-8094
Practice Address - Street 1:PLAZA ITURREGUI
Practice Address - Street 2:SUITE 217-A 65 INFANTERIA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-0000
Practice Address - Country:US
Practice Address - Phone:787-768-5501
Practice Address - Fax:787-768-8094
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR60161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical