Provider Demographics
NPI:1962287920
Name:CLINICA DORSAL LLC
Entity type:Organization
Organization Name:CLINICA DORSAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ORLIANY
Authorized Official - Middle Name:
Authorized Official - Last Name:ORTIZ TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:787-585-5615
Mailing Address - Street 1:PO BOX 1435
Mailing Address - Street 2:
Mailing Address - City:OROCOVIS
Mailing Address - State:PR
Mailing Address - Zip Code:00720-1435
Mailing Address - Country:US
Mailing Address - Phone:787-585-5615
Mailing Address - Fax:
Practice Address - Street 1:35 CALLE 4 DE JULIO
Practice Address - Street 2:
Practice Address - City:OROCOVIS
Practice Address - State:PR
Practice Address - Zip Code:00720-4433
Practice Address - Country:US
Practice Address - Phone:787-585-5615
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center