Provider Demographics
NPI:1336438993
Name:DR. NORBERTO ORTIZ CASTRO
Entity Type:Organization
Organization Name:DR. NORBERTO ORTIZ CASTRO
Other - Org Name:DR. NORBERTO ORTIZ CASTRO
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:FAMILY PRACTICE
Authorized Official - Prefix:DR
Authorized Official - First Name:NORBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:ORTIZ CASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:13218
Authorized Official - Phone:787-827-1110
Mailing Address - Street 1:STE 1 # 82 CALLE- MATIAS BRUGMAN
Mailing Address - Street 2:
Mailing Address - City:LAS MARIAS
Mailing Address - State:PR
Mailing Address - Zip Code:00670
Mailing Address - Country:US
Mailing Address - Phone:787-827-1110
Mailing Address - Fax:787-827-1110
Practice Address - Street 1:HC 3 BOX 37764
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-9327
Practice Address - Country:US
Practice Address - Phone:787-827-1110
Practice Address - Fax:787-827-1110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13218305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization