Provider Demographics
NPI:1427077528
Name:ORTIZ ACOSTA, MARITZA (MD)
Entity type:Individual
Prefix:DR
First Name:MARITZA
Middle Name:
Last Name:ORTIZ ACOSTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5282
Mailing Address - Street 2:
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698-5282
Mailing Address - Country:US
Mailing Address - Phone:787-368-7161
Mailing Address - Fax:
Practice Address - Street 1:#672 LOS ROBLES
Practice Address - Street 2:URB. CANAS
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00731
Practice Address - Country:US
Practice Address - Phone:787-368-7161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR126572084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0090036Medicare ID - Type Unspecified
PRH03241Medicare UPIN