Provider Demographics
NPI:1912045790
Name:ORTIZ, MARIA C (PHARMACIST)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:C
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 173
Mailing Address - Street 2:
Mailing Address - City:YABUCOA
Mailing Address - State:PR
Mailing Address - Zip Code:00767-0173
Mailing Address - Country:US
Mailing Address - Phone:787-893-3590
Mailing Address - Fax:787-893-3984
Practice Address - Street 1:52 CALLE CRISTOBAL COLON
Practice Address - Street 2:
Practice Address - City:YABUCOA
Practice Address - State:PR
Practice Address - Zip Code:00767-3340
Practice Address - Country:US
Practice Address - Phone:787-893-3590
Practice Address - Fax:787-893-3984
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1442365183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1442365OtherPHARMACIST