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Individual

JULIARA ENID ORTIZ SANTANA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
CENTRO MEDICO DE PR, BO. MONACILLOS, SAN JUAN, PR 00921
(787) 480-2700
Mailing address
PO BOX 381, HATILLO, PR 00659-0381
(787) 361-5516

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
22771
PR
208D00000X
General Practice Physician
35044R
PR
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6233556
DRIVER'S LICENSE
PR
Enumeration date
06/26/2020
Last updated
06/17/2022
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