Provider Demographics
NPI:1760204184
Name:HOMS ORTIZ, ANTHONY (DC)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:
Last Name:HOMS ORTIZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. SANTA RITA 3, CALLE SANTA MARIA
Mailing Address - Street 2:1431
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780
Mailing Address - Country:US
Mailing Address - Phone:787-901-4856
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA #2 ESQUINA 167
Practice Address - Street 2:BAY SHOPPING CITY BAYAMON 6107
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-221-3971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1011111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor