# PROSPERITUS PSC

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

## Provider details

- **NPI number:** 1649525874
- **Authorized official:** DR. HIRAM D ORTEGA M.D (PRESIDENT)
- **Authorized official phone:** (787) 529-1699

## Contact information

- **Practice address:** 400 CARR 176 APT 605, SAN JUAN, PR 00926-6680
- **Practice address phone:** (787) 529-1699
- **Mailing address:** 400 CARR 176 APT 605, SAN JUAN, PR 00926-6680
- **Mailing address phone:** (787) 529-1699

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | 2903 | PR | Yes |
| 207RG0100X | Gastroenterology Physician | 17586 | PR | — |

## Other

- **Enumeration date:** 07/13/2012
- **Last updated:** 07/13/2012