Organization
PROSPERITUS PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HIRAM D ORTEGA M.D (PRESIDENT)
(787) 529-1699
Entity
Organization
Contact information
Practice address
400 CARR 176 APT 605, SAN JUAN, PR 00926-6680
(787) 529-1699
Mailing address
400 CARR 176 APT 605, SAN JUAN, PR 00926-6680
(787) 529-1699
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
2903
PR
207RG0100X
Gastroenterology Physician
17586
PR
Other
Enumeration date
07/13/2012
Last updated
07/13/2012
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