Provider Demographics
NPI:1891914701
Name:ORTIZ-RIVERA, HECTOR M (MD)
Entity Type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:M
Last Name:ORTIZ-RIVERA
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:PO BOX 361585
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-1585
Mailing Address - Country:US
Mailing Address - Phone:787-383-8375
Mailing Address - Fax:787-790-5584
Practice Address - Street 1:2121 CALLE DELFOS
Practice Address - Street 2:ALTO APOLO
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-4933
Practice Address - Country:US
Practice Address - Phone:787-383-8375
Practice Address - Fax:787-790-5584
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR7631208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2-9091ORMedicare UPIN