Provider Demographics
NPI:1023561792
Name:ORTIZ TORRES, MICHAEL JAVIER
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JAVIER
Last Name:ORTIZ TORRES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8835 SILVER OAK LN NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87113-2570
Mailing Address - Country:US
Mailing Address - Phone:573-823-7457
Mailing Address - Fax:
Practice Address - Street 1:201 CEDAR ST SE STE 5630
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-4920
Practice Address - Country:US
Practice Address - Phone:505-563-1031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-29
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2025-0588207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery