Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 45472 | KY |
N | 208000000X | Pediatrician | 45472 | KY |
NPI | 1154587541 |
---|---|
Provider Name | Karen Rosario Ortiz |
First Address | Louisville, KY 40295-0202 |
Second Address | Louisville, KY 40241-2845 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2008 |
Last Update Date | 18/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
141794 | SIHO - COOL (01) | KY |
7100225360 | (05) | KY |