Provider Demographics
NPI:1578687299
Name:GARCIA ORTIZ, REBECCA P (MD)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:P
Last Name:GARCIA ORTIZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:GARDEN HILLS PLAZA
Mailing Address - Street 2:1353 CARR.19 PMB #386
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CALLE PAVIA CHINEA 655
Practice Address - Street 2:CUARTO PISO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927
Practice Address - Country:US
Practice Address - Phone:787-728-2479
Practice Address - Fax:787-726-7447
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14280207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0023170Medicare PIN