Provider Demographics
NPI:1063199800
Name:ORTIZ MORALES, CHRISTOPHER G
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:G
Last Name:ORTIZ MORALES
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:URB. CORREO VILLA AVE TEJAS AA2 PMB 133
Mailing Address - Street 2:C3 R20
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791
Mailing Address - Country:US
Mailing Address - Phone:787-344-2310
Mailing Address - Fax:
Practice Address - Street 1:(787) 535-1001
Practice Address - Street 2:
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00737
Practice Address - Country:US
Practice Address - Phone:787-535-1001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program