Provider Demographics
NPI:1043193055
Name:ORTIZ SANTANA, DENICE J
Entity type:Individual
Prefix:
First Name:DENICE
Middle Name:J
Last Name:ORTIZ SANTANA
Suffix:
Gender:F
Credentials:
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 2243
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-2243
Mailing Address - Country:US
Mailing Address - Phone:787-412-2728
Mailing Address - Fax:
Practice Address - Street 1:HWY PR2 KM 49.5
Practice Address - Street 2:EDIFICIO GM SUITE 7
Practice Address - City:MANATI, PR
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-884-0732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-28
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7037103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist