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Individual

MR. RAUL ORTIZ JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
100 ISLETA BLVD SW, ALBUQUERQUE, NM 87105-3818
(505) 200-2647
(505) 200-2695
Mailing address
6805 OLD MESA DR NW, ALBUQUERQUE, NM 87120-3876
(505) 506-1928

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP-02211
NM

Other

Enumeration date
07/16/2013
Last updated
07/16/2013
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