# MJOM ENT LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164379111
- **Authorized official:** DR. MARIANA J ORTIZ MARTINEZ MD (PRESIDENT)
- **Authorized official phone:** (787) 679-6513

## Contact information

- **Practice address:** 1789 CARR 21 STE 202, SAN JUAN, PR 00921-3335
- **Practice address phone:** (787) 679-6513
- **Mailing address:** 1789 CARR 21 STE 202, SAN JUAN, PR 00921-3335
- **Mailing address phone:** (787) 679-6513

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Y00000X | Otolaryngology Physician | — | NULL | Yes |
| 207Y00000X | Otolaryngology Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/10/2026
- **Last updated:** 03/10/2026