Provider Demographics
NPI:1861530495
Name:SOCIEDAD ORTIZ-ANNEXY GASTROENTEROLOGIA
Entity type:Organization
Organization Name:SOCIEDAD ORTIZ-ANNEXY GASTROENTEROLOGIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-884-5368
Mailing Address - Street 1:PO BOX 1036
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-1036
Mailing Address - Country:US
Mailing Address - Phone:787-884-5368
Mailing Address - Fax:787-884-0881
Practice Address - Street 1:A4 CALLE MARGINAL
Practice Address - Street 2:
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-4903
Practice Address - Country:US
Practice Address - Phone:787-884-5368
Practice Address - Fax:787-884-0881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA4270OtherIMC PROV. NUMBER
PR83925SOOtherTRIPLE S PROV. NUMBER