Provider Demographics
NPI:1245092626
Name:ORTIZ FLORES, KAMALICH VICTORIA (RN)
Entity type:Individual
Prefix:
First Name:KAMALICH
Middle Name:VICTORIA
Last Name:ORTIZ FLORES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ALTURAS DE RIO GRANDE
Mailing Address - Street 2:CALLE 14D 57D
Mailing Address - City:RIO GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00745
Mailing Address - Country:US
Mailing Address - Phone:787-373-8838
Mailing Address - Fax:
Practice Address - Street 1:ALTURAS DE RIO GRANDE
Practice Address - Street 2:CALLE 14D 57D
Practice Address - City:RIO GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00745
Practice Address - Country:US
Practice Address - Phone:787-373-8838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR100248163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse