Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YP0228X | Pediatric Otolaryngology | 17845 | PR |
NPI | 1770780629 |
---|---|
Provider Name | Melissa Ortiz-Hernandez |
First Address | Santurce, PR 00912 |
Second Address | Santurce, PR 00912 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2007 |
Last Update Date | 29/08/2012 |