Healthcare Provider Details

I. General information

NPI: 1205486255
Provider Name (Legal Business Name): MARY LIZ PIZARRO ORTIZ CASE MANAGER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2019
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 W VINE ST STE 278
KISSIMMEE FL
34741-4673
US

IV. Provider business mailing address

3501 W VINE ST SUITE 278
KISSIMMEE FL
34741
US

V. Phone/Fax

Practice location:
  • Phone: 321-900-5786
  • Fax:
Mailing address:
  • Phone: 321-900-5786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberISW21734
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: