Provider Demographics
NPI:1316975345
Name:ORTIZ VELEZ, JOSE M (MD)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:M
Last Name:ORTIZ VELEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:HACIENDA SAN JOSE , # 94 VIA MORENILLA
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727-3008
Mailing Address - Country:US
Mailing Address - Phone:787-744-8370
Mailing Address - Fax:
Practice Address - Street 1:T1-11 , CALLE 28
Practice Address - Street 2:TURABO GARDENS
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-0000
Practice Address - Country:US
Practice Address - Phone:787-744-8370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11445207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRPE4818OtherPALIC PROVIDER
PR100767OtherCRUZ AZUL DE PR
PR212904OtherPREFERRED HEALTH
PR2995OtherPREFERRED MEDICARE CHOICE
PR11511445OtherGLOBAL HEALTH
PR400317OtherMEDICARE Y MUCHO MAS
PR9900521OtherHUMANA HEALTH PLAN
PRA272OtherFIRST MEDICAL
PR9900521OtherHUMANA INSURANCE
PR22572OtherTRIPLE S
PRI14389Medicare UPIN
PR0022572Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER