Individual
JUAN M ORTIZ COLON SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
950 CARR 891 STE 19, COROZAL, PR 00783
(787) 859-7958
(787) 859-7958
Mailing address
950 CARR 891 ST 19, COROZAL, PR 00783
(787) 859-7958
(787) 859-7958
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
187
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
58009
SSS
PR
01
—
660444808
MCS
—
05
—
660806855
—
PR
Enumeration date
12/06/2006
Last updated
08/19/2022
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