Provider Demographics
NPI:1871500058
Name:ORTIZ JIMENEZ, ANA EMILIA (MEDICAL TECHNOLOGIST)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:EMILIA
Last Name:ORTIZ JIMENEZ
Suffix:
Gender:F
Credentials:MEDICAL TECHNOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2054 AVE PEDRO ALBIZU CAMPOS
Mailing Address - Street 2:SUITE # 2
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603-6009
Mailing Address - Country:US
Mailing Address - Phone:787-891-4216
Mailing Address - Fax:
Practice Address - Street 1:2054 AVE PEDRO ALBIZU CAMPOS
Practice Address - Street 2:SUITE # 2
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603-6009
Practice Address - Country:US
Practice Address - Phone:787-891-4216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR566291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory