Individual provider Active NPI

Marlacoral Ortiz Gonzalez, MD

  • General Practice Physician
  • Aibonito, PR
National Provider Identifier
1477293603
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
23892 Issued in PR
Practice address
Urb. Bella Vista C7 Calle Violeta
Aibonito, PR 00705
Phone
(787) 595-9879
NPI assigned
Mar 29, 2022
Last updated
Aug 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 23892 PR Primary

Addresses

Primary practice location

Urb. Bella Vista C7 Calle Violeta
Aibonito, PR 00705

Mailing address

Urb. Bella Vista C7 Calle Violeta
Aibonito, PR 00705
Phone (787) 595-9879

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address marlacoral.ortiz@outlook.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
23892PRMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1477293603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB. BELLA VISTA C7 CALLE VIOLETA",
            "city": "AIBONITO",
            "state": "PR",
            "postal_code": "00705",
            "telephone_number": "787-595-9879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB. BELLA VISTA C7 CALLE VIOLETA",
            "city": "AIBONITO",
            "state": "PR",
            "postal_code": "00705",
            "telephone_number": "787-595-9879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ GONZALEZ",
        "first_name": "MARLACORAL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-29",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "23892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "marlacoral.ortiz@outlook.com",
            "affiliation": "N",
            "address_1": "urb. Bella Vista c7 calle Violeta",
            "city": "Aibonito",
            "state": "PR",
            "country_code": "US",
            "postal_code": "00705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Aibonito, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.