Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 036149518 | IL |
NPI | 1710398342 |
---|---|
Provider Name | Juan Francisco Ortiz |
First Address | Tucson, AZ 85724-0001 |
Second Address | Tucson, AZ 85724-2986 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2014 |
Last Update Date | 18/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1710398342 | NPI (01) |