Provider Demographics
NPI:1679625651
Name:ORTIZ GONZALEZ, ELIZABETH (PHARMACY TECHNICIAN)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:
Last Name:ORTIZ GONZALEZ
Suffix:
Gender:F
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC-02 BOX 9924
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00971
Mailing Address - Country:US
Mailing Address - Phone:787-646-0246
Mailing Address - Fax:
Practice Address - Street 1:7 CALLE MUNOZ RIVERA
Practice Address - Street 2:PUEBLO
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-5705
Practice Address - Country:US
Practice Address - Phone:787-720-2196
Practice Address - Fax:787-720-2196
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3470183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician