Provider / Organization | NPI | Date Certified |
---|---|---|
RAUL D ORTIZ | 1245810548 | 2021-04-11 |
Raul D Ortiz is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1245810548. Registration indicates Raul D Ortiz is a provider of services with a specialization in Student, Health Care, Student in an Organized Health Care Education/Training Program (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care) Access to Dentists-General (Dental Providers, Dentist) (Dental Providers, Dentist) (Dentist, ) (Dental, ) (Dentist, Dental Providers)
Entity Type | Individual |
Provider Name | Raul D Ortiz |
Practice Office Address | 43 CALLE BALDORIOTY STE 3 COAMO, PR US |
Practice Office Telephone | 7878250222 |
Mailing Address | 43 CALLE BALDORIOTY STE 3 COAMO, PR 007693120 US |
Business Telephone | 7878250222 |
Business Fax | 7874717358 |
Address | City / State | Phone / Fax |
---|---|---|
111 E 210th St | Bronx, NY 104672401 | 7189206054 |
Code | Practice | License No State |
---|---|---|
390200000X | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care | |
122300000X PRIMARY | Access to Dentists-General Dental Providers Dentist Dental Providers Dentist Dentist Dental Dentist Dental Providers | 3399
PR |
039246900 | MEDICAID | PR |