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NPI Code Detail

MEDICARE: MS. YOLANDA ORTIZ LCSW

MEDICARE: MS. YOLANDA ORTIZ LCSW
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
11041C0700XClinical Social WorkerSW 12193FL

General Provider Information

NPI Number : 1679703714
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. YOLANDA ORTIZ LCSW
Provider Business Mailing Address
First Line : 1520 BOTTLEBRUSH DR NE
Second Line : STE 5
City : PALM BAY
State : FL
Zip : 32905-3138
Country : US
Telephone Number : 321-421-6992
Fax Number : 321-421-6993
Provider Business Practice Location Address
First Line : 1520 BOTTLEBRUSH DR NE
Second Line : STE 5
City : PALM BAY
State : FL
Zip : 32905-3138
Country : US
Telephone Number : 321-421-6992
Fax Number : 321-421-6993
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2009
Last Update Date : 08/29/2020

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