Provider Demographics
NPI:1588694053
Name:ORTIZ, LUZ E
Entity type:Individual
Prefix:
First Name:LUZ
Middle Name:E
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PMB 202
Mailing Address - Street 2:PO BOX 29029
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00929-0029
Mailing Address - Country:US
Mailing Address - Phone:787-402-3821
Mailing Address - Fax:787-750-2636
Practice Address - Street 1:1103 CALLE CELIA CESTERO
Practice Address - Street 2:COUNTRY CLUB
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00924-2464
Practice Address - Country:US
Practice Address - Phone:787-402-3821
Practice Address - Fax:787-750-2636
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR247000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247000000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Health Information