Organization
MOH PEDS OTO CSP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MELISSA ORTIZ HERNANDEZ MD (PRESIDENT)
(787) 268-2300
Entity
Organization
Contact information
Practice address
252 CALLE SAN JORGE STE 501, SAN JORGE MEDICAL BUILDING, SAN JUAN, PR 00912-3241
(787) 268-2300
(787) 268-3055
Mailing address
PO BOX 362707, SAN JUAN, PR 00936-2707
(787) 268-2300
(787) 268-3055
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
11/28/2012
Last updated
11/28/2012
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