Individual provider Active NPI

Zoraida Fontain Ortiz

  • Medical Technologist
  • San Juan, PR
National Provider Identifier
1073780649
Registry record updated Nov 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical TechnologistTaxonomy code 246QM0706X
License
3018 Issued in PR
Practice address
969 Calle Eider
Country Club
San Juan, PR 00924-2335
Phone
(787) 757-1305
NPI assigned
May 13, 2008
Last updated
Nov 5, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Technologist 246QM0706X 3018 PR Primary
Other Specialist/Technologist 246Z00000X

Addresses

Primary practice location

969 Calle Eider
Country Club
San Juan, PR 00924-2335

Mailing address

969 Calle Eider
Country Club
San Juan, PR 00924-2335
Phone (787) 757-1305

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080514000790 PR Part B Supplier - Independent Clinical Laboratory 9335218502 Practice locations: San Juan, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
938PRMDNutrition Education Nutritionist
3018PRMDMedical Technologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383609600000",
    "number": "1073780649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "969 CALLE EIDER",
            "address_2": "COUNTRY CLUB",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009242335",
            "telephone_number": "787-757-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "969 CALLE EIDER",
            "address_2": "COUNTRY CLUB",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009242335",
            "telephone_number": "787-757-1305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTAIN ORTIZ",
        "first_name": "ZORAIDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-13",
        "last_updated": "2013-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246QM0706X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Pathology, Medical Technologist",
            "state": "PR",
            "license": "3018",
            "primary": true
        },
        {
            "code": "246Z00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.