Provider Demographics
NPI:1366507907
Name:ORTIZ-PAGAN, MARTA R (MD)
Entity type:Individual
Prefix:MISS
First Name:MARTA
Middle Name:R
Last Name:ORTIZ-PAGAN
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 5430
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-5430
Mailing Address - Country:US
Mailing Address - Phone:787-263-1010
Mailing Address - Fax:787-743-7153
Practice Address - Street 1:HOSPITAL MENONITA CAYEY OFICINA 203
Practice Address - Street 2:EDIFICIO PROFESIONAL AVE LAUREL
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736
Practice Address - Country:US
Practice Address - Phone:787-263-1010
Practice Address - Fax:787-263-1011
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8372207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
297000RMedicare ID - Type Unspecified
C77710Medicare UPIN