Individual
MAILLIM ILIA ORTIZ LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
29 CALLE BASILIO CATALA APT 1305, GUAYNABO, PR 00971-7606
(787) 422-2678
Mailing address
PO BOX 2711, BAYAMON, PR 00960-2711
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/22/2024
Last updated
03/22/2024
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