MEDICARE: MRS. MARIA D ORTIZ SOCIAL WORKER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor		FL

General Provider Information

NPI Number	:	1093982803
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARIA D ORTIZ SOCIAL WORKER

Provider Business Mailing Address
First Line	:	215 E PALM AVE
Second Line	:	APT 709
City	:	TAMPA
State	:	FL
Zip	:	33602-2236
Country	:	US
Telephone Number	:	813-480-7984
Fax Number	:	813-223-6983

Provider Business Practice Location Address
First Line	:	215 E PALM AVE
Second Line	:	APT 709
City	:	TAMPA
State	:	FL
Zip	:	33602-2236
Country	:	US
Telephone Number	:	813-480-7984
Fax Number	:	813-223-6983

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2008
Last Update Date	:	05/12/2008

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