Provider Demographics
NPI:1881678514
Name:ORTIZ SANCHO, RAYDA E (MD)
Entity Type:Individual
Prefix:DR
First Name:RAYDA
Middle Name:E
Last Name:ORTIZ SANCHO
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:CARDENAS 1231PUERTO NUEVO
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00920
Mailing Address - Country:US
Mailing Address - Phone:787-783-9417
Mailing Address - Fax:
Practice Address - Street 1:CONDADO ASTOV ASHFORD 1018
Practice Address - Street 2:OFFICE 3D
Practice Address - City:SANTURCE
Practice Address - State:PR
Practice Address - Zip Code:00907
Practice Address - Country:US
Practice Address - Phone:787-722-6237
Practice Address - Fax:787-722-6235
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-06
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7114207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E30431Medicare UPIN
98947Medicare ID - Type Unspecified