Provider Demographics
NPI:1841630811
Name:ORTIZ ORTIZ, LORIMAR (MD)
Entity type:Individual
Prefix:
First Name:LORIMAR
Middle Name:
Last Name:ORTIZ ORTIZ
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:PO BOX 7
Mailing Address - Street 2:
Mailing Address - City:COAMO
Mailing Address - State:PR
Mailing Address - Zip Code:00769-0007
Mailing Address - Country:US
Mailing Address - Phone:787-416-1010
Mailing Address - Fax:364-202-9215
Practice Address - Street 1:1123 AVE HOSTOS
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-0952
Practice Address - Country:US
Practice Address - Phone:787-416-1010
Practice Address - Fax:364-202-9215
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-04
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19,071207Q00000X, 390200000X
282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No282N00000XHospitalsGeneral Acute Care Hospital