Provider Demographics
NPI:1902598550
Name:ORTIZ VEGA, MERCEDES DEL CARMEN (MTS)
Entity Type:Individual
Prefix:
First Name:MERCEDES
Middle Name:DEL CARMEN
Last Name:ORTIZ VEGA
Suffix:
Gender:F
Credentials:MTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1042
Mailing Address - Street 2:
Mailing Address - City:CATANO
Mailing Address - State:PR
Mailing Address - Zip Code:00963-1042
Mailing Address - Country:US
Mailing Address - Phone:787-788-4544
Mailing Address - Fax:787-788-4544
Practice Address - Street 1:166 AVE BARBOSA
Practice Address - Street 2:
Practice Address - City:CATANO
Practice Address - State:PR
Practice Address - Zip Code:00962-4782
Practice Address - Country:US
Practice Address - Phone:787-788-4544
Practice Address - Fax:787-788-4544
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR164131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical