Provider Demographics
NPI:1831066414
Name:ORTIZ, ANIBAL J SR
Entity type:Individual
Prefix:
First Name:ANIBAL
Middle Name:J
Last Name:ORTIZ
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 551
Mailing Address - Street 2:
Mailing Address - City:PENUELAS
Mailing Address - State:PR
Mailing Address - Zip Code:00624-0551
Mailing Address - Country:US
Mailing Address - Phone:787-590-6371
Mailing Address - Fax:
Practice Address - Street 1:58 CALLE UN
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00915-2449
Practice Address - Country:US
Practice Address - Phone:787-590-6371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-20
Last Update Date:2025-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1906225CX0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225CX0006XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorOrientation and Mobility Training ProviderGroup - Single Specialty