Provider Demographics
NPI:1891441010
Name:ORTIZ RIVERA, ANIBAL JOSE (MD)
Entity Type:Individual
Prefix:DR
First Name:ANIBAL
Middle Name:JOSE
Last Name:ORTIZ RIVERA
Suffix:
Gender:M
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:CARR 152 KM8.0
Mailing Address - Street 2:BP. QUEBRADILLA
Mailing Address - City:BARRANQUITA
Mailing Address - State:PR
Mailing Address - Zip Code:00794
Mailing Address - Country:US
Mailing Address - Phone:787-857-0300
Mailing Address - Fax:
Practice Address - Street 1:CARR 152 KM 8.0
Practice Address - Street 2:BO QUEBRADILLA
Practice Address - City:BARRANQUITAS
Practice Address - State:PR
Practice Address - Zip Code:00794
Practice Address - Country:US
Practice Address - Phone:787-857-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-25
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22628208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice