Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 8159 | PR |
Y | 208D00000X | General Practice Physician | 8159 | PR |
NPI | 1033110275 |
---|---|
Provider Name | Hiram Ortega Nieves |
First Address | Aguada, PR 00602-0998 |
Second Address | Aguada, PR 00602-3115 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2005 |
Last Update Date | 07/12/2010 |