Provider Demographics
NPI:1801107073
Name:LORTIZ CARDIOVASCULAR MEDICINE PSC
Entity type:Organization
Organization Name:LORTIZ CARDIOVASCULAR MEDICINE PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-795-6550
Mailing Address - Street 1:COND COLINA REAL APT 1101
Mailing Address - Street 2:FELIZA GAUTIER
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-798-6550
Mailing Address - Fax:787-798-6590
Practice Address - Street 1:COND CORAL INN APT 1101
Practice Address - Street 2:FELIZA GAUTIER
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-1454
Practice Address - Country:US
Practice Address - Phone:787-798-6550
Practice Address - Fax:787-798-6590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-23
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14849261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR=========OtherEMPLOYER IDENTIFICATION NUMBER