Provider Demographics
NPI:1891365516
Name:COMAS ORTIZ, JUAN A (MD)
Entity type:Individual
Prefix:DR
First Name:JUAN
Middle Name:A
Last Name:COMAS 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:PO BOX 1235
Mailing Address - Street 2:
Mailing Address - City:SABANA GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00637-1235
Mailing Address - Country:US
Mailing Address - Phone:787-400-3786
Mailing Address - Fax:
Practice Address - Street 1:CARR 363 KM 0.1
Practice Address - Street 2:REPARTO SANTA ANA
Practice Address - City:SABANA GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00637-1235
Practice Address - Country:US
Practice Address - Phone:787-400-3786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-25
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR23393208D00000X, 208D00000X
PR00571363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical