Provider Demographics
NPI:1548468804
Name:CALDERON ORTIZ, RICARDO M (MD)
Entity type:Individual
Prefix:
First Name:RICARDO
Middle Name:M
Last Name:CALDERON ORTIZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 REINA DE LAS FLORES
Mailing Address - Street 2:SABANERA DEL RIO
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778
Mailing Address - Country:US
Mailing Address - Phone:787-366-7961
Mailing Address - Fax:
Practice Address - Street 1:CALLE 66 # 694
Practice Address - Street 2:URB. VEREDAS
Practice Address - City:GURABO
Practice Address - State:PR
Practice Address - Zip Code:00777
Practice Address - Country:US
Practice Address - Phone:787-366-7961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17630207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology