Organization
CENTRO PEDIATRICO ESTRELLITA DORADA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIRZA I ORTIZ MD (PRESIDENTA)
(787) 473-0242
Entity
Organization
Contact information
Practice address
CARR 693 KM 14.6, BO SABANA, VEGA ALTA, PR 00692
(787) 473-0242
Mailing address
PO BOX 1720, DORADO, PR 00646-1720
(787) 473-0242
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1999
PEDIATRICO
PR
Enumeration date
10/10/2018
Last updated
10/10/2018
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