Provider Demographics
NPI:1770780629
Name:ORTIZ-HERNANDEZ, MELISSA (MD)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:ORTIZ-HERNANDEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HOSPITAL SAN JORGE
Mailing Address - Street 2:AVE. SAN JORGE 252 SUITE 501
Mailing Address - City:SANTURCE
Mailing Address - State:PR
Mailing Address - Zip Code:00912
Mailing Address - Country:US
Mailing Address - Phone:787-268-2300
Mailing Address - Fax:787-268-3055
Practice Address - Street 1:HOSPITAL SAN JORGE
Practice Address - Street 2:AVE. SAN JORGE 252 SUITE 501
Practice Address - City:SANTURCE
Practice Address - State:PR
Practice Address - Zip Code:00912
Practice Address - Country:US
Practice Address - Phone:787-268-2300
Practice Address - Fax:787-268-3055
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17845207YP0228X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric Otolaryngology