Individual
SORIVETTE SURILLO-ORTIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
AVE EL JIBARO CARR #172 KM 13.5 BO BAYAMON, CIDRA, PR 00739-3714
(787) 739-8182
Mailing address
PMB #238 PO BOX 4960, CAGUAS, PR 00726-4960
(787) 236-2422
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21946
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125071436
STATE LICENSE NUMBER
IL
Enumeration date
07/07/2017
Last updated
03/12/2021
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