Provider Demographics
NPI:1841592565
Name:ORTEGA RIOS, MARIA DEL MAR (MD)
Entity type:Individual
Prefix:
First Name:MARIA DEL MAR
Middle Name:
Last Name:ORTEGA RIOS
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:T4 CALLE ALCAZAR
Mailing Address - Street 2:URB. VILLA ESPANA
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-7312
Mailing Address - Country:US
Mailing Address - Phone:787-787-5412
Mailing Address - Fax:
Practice Address - Street 1:T4 CALLE ALCAZAR
Practice Address - Street 2:URB. VILLA ESPANA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-7312
Practice Address - Country:US
Practice Address - Phone:787-787-5412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-01
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18041208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice