Individual
JUAN C ORTIZ PEREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14139 POTOMAC MILLS RD, WOODBRIDGE, VA 22192-4644
(703) 359-7878
Mailing address
14139 POTOMAC MILLS RD, WOODBRIDGE, VA 22192-4644
(703) 359-7878
(804) 739-8923
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
0101261727
VA
Other
Enumeration date
06/06/2014
Last updated
06/22/2021
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