Provider Demographics
NPI:1841331733
Name:ORTIZ RODRIGUEZ, VERONICA (MD)
Entity type:Individual
Prefix:MRS
First Name:VERONICA
Middle Name:
Last Name:ORTIZ RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MRS
Other - First Name:VERONICA
Other - Middle Name:
Other - Last Name:ORTIZ RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 7128
Mailing Address - Street 2:MIGRANT HEALTH CENTER INC
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-7128
Mailing Address - Country:US
Mailing Address - Phone:787-805-2900
Mailing Address - Fax:787-834-1924
Practice Address - Street 1:MIGRANT HEALTH CENTER, INC
Practice Address - Street 2:CARR 101 KM 7.1 BO PALMAREJO
Practice Address - City:LAJAS
Practice Address - State:PR
Practice Address - Zip Code:00667
Practice Address - Country:US
Practice Address - Phone:787-808-0897
Practice Address - Fax:787-808-1420
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11219208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR89635Medicare ID - Type UnspecifiedMEDICARE
PRG04583Medicare UPIN