Provider Demographics
NPI:1841340213
Name:ORTIZ, KEILA ZOE (PT)
Entity type:Individual
Prefix:
First Name:KEILA
Middle Name:ZOE
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 AVE SAN IGNACIO
Mailing Address - Street 2:BOX 32
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921-4706
Mailing Address - Country:US
Mailing Address - Phone:787-793-2094
Mailing Address - Fax:
Practice Address - Street 1:89 CALLE AMAPOLA
Practice Address - Street 2:URB JARDINES DE NARANJITO
Practice Address - City:NARANJITO
Practice Address - State:PR
Practice Address - Zip Code:00719-4413
Practice Address - Country:US
Practice Address - Phone:787-633-5964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1273225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist