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NPI Code Detail

MEDICARE: MICHAEL LORENZO ORTIZ

MEDICARE: MICHAEL LORENZO ORTIZ
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
1225200000XPhysical Therapy Assistant

General Provider Information

NPI Number : 1942945126
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL LORENZO ORTIZ
Provider Business Mailing Address
First Line : 15141 DADE AVE
Second Line :
City : DADE CITY
State : FL
Zip : 33523-2315
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1114 CHATMAN BLVD
Second Line :
City : BROOKSVILLE
State : FL
Zip : 34601-3104
Country : US
Telephone Number : 352-796-6701
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2022
Last Update Date : 05/02/2022

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Directions to “ MICHAEL LORENZO ORTIZ ” Practice Location

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