Provider Demographics
NPI:1982662110
Name:ORTIZ, ANA LUISA (MS, PHL)
Entity Type:Individual
Prefix:MRS
First Name:ANA
Middle Name:LUISA
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:MS, PHL
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 3435
Mailing Address - Street 2:
Mailing Address - City:JUNCOS
Mailing Address - State:PR
Mailing Address - Zip Code:00777-2786
Mailing Address - Country:US
Mailing Address - Phone:787-734-6780
Mailing Address - Fax:787-734-6780
Practice Address - Street 1:CALLE 14 #228 LAS PINAS
Practice Address - Street 2:JUNCOS
Practice Address - City:JUNCOS
Practice Address - State:PR
Practice Address - Zip Code:00777-2786
Practice Address - Country:US
Practice Address - Phone:787-734-6780
Practice Address - Fax:787-734-6780
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR579235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR33-02-86-5OtherACAA
PRP 6029OtherCRUZ AZUL P.R.