Provider Demographics
NPI:1427599695
Name:ORTIZ RODRIGUEZ, ANGEL LUIS
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:LUIS
Last Name:ORTIZ RODRIGUEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:ANGEL
Other - Middle Name:LUIS
Other - Last Name:ORTIZ RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:HOSPITAL MENONITA GUAYAMA
Mailing Address - Street 2:AVE PEDRO ALBIZU CAMPOS URB LA HACIENDA
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00784-0011
Mailing Address - Country:US
Mailing Address - Phone:787-864-4300
Mailing Address - Fax:
Practice Address - Street 1:HOSPITAL MENONITA GUAYAMA
Practice Address - Street 2:AVE PEDRO ALBIZU CAMPOS URB LA HACIENDA
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784-0011
Practice Address - Country:US
Practice Address - Phone:787-864-4300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-20
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22514207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program