Provider Demographics
NPI:1699113837
Name:ORTEGA, NORIAM GOMEZ (PTA)
Entity type:Individual
Prefix:MS
First Name:NORIAM
Middle Name:GOMEZ
Last Name:ORTEGA
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:H C 3 BOX 18302
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE
Mailing Address - State:P.R
Mailing Address - Zip Code:00745
Mailing Address - Country:UM
Mailing Address - Phone:787-605-0259
Mailing Address - Fax:
Practice Address - Street 1:HC 3 BOX 18302
Practice Address - Street 2:
Practice Address - City:RIO GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00745-9747
Practice Address - Country:US
Practice Address - Phone:787-605-0259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-10
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1869225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant