Provider Demographics
NPI:1891752663
Name:SANCHEZ ORTA, IRIS GLENYS (AUDIOLOGIST MSA)
Entity Type:Individual
Prefix:
First Name:IRIS
Middle Name:GLENYS
Last Name:SANCHEZ ORTA
Suffix:
Gender:F
Credentials:AUDIOLOGIST MSA
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Other - First Name:
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Mailing Address - Street 1:VILLA NEVAREZ PROF CENTER
Mailing Address - Street 2:SUITE 402
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927
Mailing Address - Country:US
Mailing Address - Phone:787-751-5609
Mailing Address - Fax:787-751-5609
Practice Address - Street 1:VILLA NEVAREZ PROF CENTER CALLE #2
Practice Address - Street 2:SUITE 402
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927
Practice Address - Country:US
Practice Address - Phone:787-751-5609
Practice Address - Fax:787-751-5609
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR553231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
P66904Medicare UPIN