Provider Demographics
NPI:1861618282
Name:ORTIZ-SANTIAGO, VICKY (MS)
Entity type:Individual
Prefix:
First Name:VICKY
Middle Name:
Last Name:ORTIZ-SANTIAGO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 1 BOX 7801
Mailing Address - Street 2:
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659-9263
Mailing Address - Country:US
Mailing Address - Phone:787-878-8917
Mailing Address - Fax:
Practice Address - Street 1:AVE SAN JORGE 252
Practice Address - Street 2:SUITE 501
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00912
Practice Address - Country:US
Practice Address - Phone:787-268-2300
Practice Address - Fax:787-268-3055
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR837235Z00000X
PR565231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist