Individual
DIMARY ORTIZ MENDEZ I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
740 AVE. HOSTOS , STE. 311, COND. MEDICAL CENTER PLAZA, MAYAGUEZ, PR 00682-1541
(787) 249-5062
Mailing address
49 CARR 307 APARTADO 108, EDIFICIOS OLAS A8, CABOQUERON RESORT, BOQUERON, PR 00622-9768
(787) 249-5062
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
14094
PR
208D00000X
General Practice Physician
ACN558
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
141306000114-001
CCN
—
01
—
DD319A
PTAN
PR
01
—
HS203A
PTAN
PR
Enumeration date
07/19/2006
Last updated
11/29/2021
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