Active NPI
Zoraida Fontain Ortiz
- Medical Technologist
- San Juan, PR
National Provider Identifier
1073780649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Technologist
- License
- 3018
- 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, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 938 | PR | MD | Nutrition Education Nutritionist |
| 3018 | PR | MD | Medical 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.