MEDICARE: LUIS ORTIZ-MUNOZ M.D.

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	207RC0000X	Cardiovascular Disease Physician	14849	PR
2	207RC0000X	Cardiovascular Disease Physician	ME115082	FL

General Provider Information

NPI Number	:	1568563401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUIS ORTIZ-MUNOZ M.D.

Provider Business Mailing Address
First Line	:	6200 SUNSET DR
Second Line	:	STE 401
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-4829
Country	:	US
Telephone Number	:	305-661-2534
Fax Number	:	305-667-2115

Provider Business Practice Location Address
First Line	:	4685 PONCE DE LEON BLVD
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33146-2108
Country	:	US
Telephone Number	:	305-661-2534
Fax Number	:	305-667-2115

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

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	02/21/2018

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