Healthcare Provider Details

I. General information

NPI: 1265344709
Provider Name (Legal Business Name): ANNETTE MARIA ORTIZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8590 SW 40TH ST
MIAMI FL
33155-3214
US

IV. Provider business mailing address

9430 SW 53RD ST
MIAMI FL
33165-6412
US

V. Phone/Fax

Practice location:
  • Phone: 305-266-5353
  • Fax:
Mailing address:
  • Phone: 305-469-2939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSZ13640
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: