Provider Demographics
NPI:1770725061
Name:ORTIZLOUATI, VANESSA
Entity type:Individual
Prefix:MS
First Name:VANESSA
Middle Name:
Last Name:ORTIZLOUATI
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:VANESSA
Other - Middle Name:
Other - Last Name:ORTIZMUNOZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:COND PASEO DEGETAU
Mailing Address - Street 2:2805
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727
Mailing Address - Country:US
Mailing Address - Phone:787-469-0378
Mailing Address - Fax:
Practice Address - Street 1:COND PASEO DEGETAU
Practice Address - Street 2:2805
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00727
Practice Address - Country:US
Practice Address - Phone:787-469-0378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-01
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2209038347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle