Provider Demographics
NPI:1013906007
Name:ORTIZ COLON, JOSE L (MD)
Entity Type:Individual
Prefix:MR
First Name:JOSE
Middle Name:L
Last Name:ORTIZ COLON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1020
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674
Mailing Address - Country:US
Mailing Address - Phone:787-854-3249
Mailing Address - Fax:787-854-2613
Practice Address - Street 1:JP REYES LOPEZ J-49 URB ATENAS
Practice Address - Street 2:
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-854-3249
Practice Address - Fax:787-854-2613
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-21
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10 185207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E22701OtherASOMEDIC
160426OtherACAA
27745OtherASOCIACION MAESTRO
PR88519OtherSSS
3920OtherAMERICAN HEALTH
8623OtherINTERNATIONAL MEDICAL CAR
PR60193OtherCRUZ AZUL
8035OtherFMPR
3920OtherAMERICAN HEALTH
E22701OtherASOMEDIC