Provider Demographics
NPI:1881729242
Name:ORTIZ, LOURDES MILAGROS
Entity type:Individual
Prefix:MRS
First Name:LOURDES
Middle Name:MILAGROS
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LOURDES
Other - Middle Name:MILAGROS
Other - Last Name:ORTIZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PLAZA 37 URB. MONTE CLARO
Mailing Address - Street 2:MQ-11
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961
Mailing Address - Country:US
Mailing Address - Phone:787-306-3233
Mailing Address - Fax:
Practice Address - Street 1:AVE. LAUREL HOSPITAL REGIONAL DE BAYAMON
Practice Address - Street 2:CENTRO PEDIATRICO DE BAYAMON
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956
Practice Address - Country:US
Practice Address - Phone:787-778-4747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR#820225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist