Individual
MYRIAM ARACELIS ORTIZ-DE JESUS'
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11424 SULLIVAN RD, SUITE B1, BATON ROUGE, LA 70818-3615
(225) 761-5200
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
16387
PR
208000000X
Pediatrics Physician
Primary
MD.09880R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09479279
—
MS
05
—
1662330
—
LA
Enumeration date
05/18/2006
Last updated
01/05/2017
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