Provider Demographics
NPI:1922775683
Name:ORTIZ ORTIZ, YAMILEX MARIE (MSN, LND)
Entity Type:Individual
Prefix:MRS
First Name:YAMILEX
Middle Name:MARIE
Last Name:ORTIZ ORTIZ
Suffix:
Gender:F
Credentials:MSN, LND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 1 BOX 4310
Mailing Address - Street 2:
Mailing Address - City:COMERIO
Mailing Address - State:PR
Mailing Address - Zip Code:00782-9707
Mailing Address - Country:US
Mailing Address - Phone:787-548-2723
Mailing Address - Fax:
Practice Address - Street 1:CARR 164 SECTOR EL DESVIO
Practice Address - Street 2:BO ACHIOTE
Practice Address - City:NARANJITO
Practice Address - State:PR
Practice Address - Zip Code:00719-0515
Practice Address - Country:US
Practice Address - Phone:787-869-1290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-30
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR002119133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist