Healthcare Provider Details

I. General information

NPI: 1841888971
Provider Name (Legal Business Name): JULIE ORTIZ PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2021
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

745 MEADOWS RD STE 100-101
BOCA RATON FL
33486-2324
US

IV. Provider business mailing address

1001 NW 13TH ST STE 201
BOCA RATON FL
33486-2269
US

V. Phone/Fax

Practice location:
  • Phone: 561-955-6784
  • Fax: 833-973-6250
Mailing address:
  • Phone: 561-955-6663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9116651
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: