Individual
LUIS E. ORTIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
680 CENTRE ST, BROCKTON, MA 02302-3308
(508) 941-7000
Mailing address
680 CENTRE ST, BROCKTON, MA 02302-3308
(508) 941-7000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
78720
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1200283
—
MA
Enumeration date
07/12/2006
Last updated
09/19/2018
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