Provider Demographics
NPI:1891783270
Name:ORTIZ, ERWIN R (MD)
Entity Type:Individual
Prefix:DR
First Name:ERWIN
Middle Name:R
Last Name:ORTIZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 4767
Mailing Address - Street 2:VALLE ARRIBA HEIGHTS STATION
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984-4767
Mailing Address - Country:US
Mailing Address - Phone:787-701-4646
Mailing Address - Fax:787-757-2361
Practice Address - Street 1:CL-1 FIDALGO DIAZ AVE.
Practice Address - Street 2:VILLA FONTANA
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983
Practice Address - Country:US
Practice Address - Phone:787-701-4646
Practice Address - Fax:787-757-2361
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-11
Last Update Date:2010-09-13
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Provider Licenses
StateLicense IDTaxonomies
PR10359208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics