Healthcare Provider Details

I. General information

NPI: 1841778867
Provider Name (Legal Business Name): AA ORTIZ MEDICAL CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2018
Last Update Date: 01/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8080 W FLAGLER ST STE 3A
MIAMI FL
33144-2100
US

IV. Provider business mailing address

8080 W FLAGLER ST STE 3A
MIAMI FL
33144-2100
US

V. Phone/Fax

Practice location:
  • Phone: 305-456-9251
  • Fax: 305-456-6682
Mailing address:
  • Phone: 305-456-9251
  • Fax: 305-456-6682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: AURELIO ORTIZ
Title or Position: PRESIDENT
Credential: MD
Phone: 305-456-9251