Provider Demographics
NPI:1023456084
Name:ORTIZ, JOSE RAMON
Entity type:Individual
Prefix:MR
First Name:JOSE
Middle Name:RAMON
Last Name:ORTIZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:B7 CALLE 2
Mailing Address - Street 2:
Mailing Address - City:CATANO
Mailing Address - State:PR
Mailing Address - Zip Code:00962-5918
Mailing Address - Country:US
Mailing Address - Phone:787-510-9386
Mailing Address - Fax:
Practice Address - Street 1:B7 CALLE 2
Practice Address - Street 2:
Practice Address - City:CATANO
Practice Address - State:PR
Practice Address - Zip Code:00962-5918
Practice Address - Country:US
Practice Address - Phone:787-510-9386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-11
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8897183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician