| Street | 1281 John Fitch Blvd | ||
| City/Town | South Windsor | ||
| State/Province/Region | Connecticut | ||
| Zip/Postal Code | 06074 | ||
| Phone Number | (860) 282-1118 | ||
| Country | United States |
| Full Name | Juwan Ortiz | ||
| Gender | male | ||
| Birthday | 1971-11-26 | ||
| Social Security Number | 476-55-8101 |
| Credit card brand | Discover | ||
| Credit card number | 6011186578296643 | ||
| Expire | 2028/2 | ||
| CVV | 130 |