Provider Demographics
NPI:1992254569
Name:ACOSTA-ORTIZ, ALEJANDRO LUIS III (MD)
Entity type:Individual
Prefix:DR
First Name:ALEJANDRO
Middle Name:LUIS
Last Name:ACOSTA-ORTIZ
Suffix:III
Gender:M
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:METRO PLAZA TOWERS CALLE VILLAMIL #305
Mailing Address - Street 2:APT. 1211
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907
Mailing Address - Country:US
Mailing Address - Phone:787-390-9593
Mailing Address - Fax:
Practice Address - Street 1:CARR 102 KM 16.4
Practice Address - Street 2:
Practice Address - City:CABO ROJO
Practice Address - State:PR
Practice Address - Zip Code:00623
Practice Address - Country:US
Practice Address - Phone:787-390-9593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-23
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22115207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty