Provider Demographics
NPI:1871851097
Name:ORTIZ, PATRICIA R (MA)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:R
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 BIRDSONG CT
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-2629
Mailing Address - Country:US
Mailing Address - Phone:305-989-9050
Mailing Address - Fax:
Practice Address - Street 1:3920 ROSEWOOD WAY
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32808-1033
Practice Address - Country:US
Practice Address - Phone:407-730-3859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ5094225500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist