Basic Information
| Provider Information | |||||||||
| NPI: | 1003016726 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ORTIZ | ||||||||
| FirstName: | EMILY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | RPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 43002 | ||||||||
| Address2: | SUITE 423 | ||||||||
| City: | RIO GRANDE | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007456601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878875667 | ||||||||
| FaxNumber: | 7878601614 | ||||||||
| Practice Location | |||||||||
| Address1: | 4203 CALLE MARGINAL | ||||||||
| Address2: | |||||||||
| City: | FAJARDO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007383652 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878601603 | ||||||||
| FaxNumber: | 7878601614 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/20/2007 | ||||||||
| LastUpdateDate: | 07/20/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 5092 | PR | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.