Healthcare Provider Details

I. General information

NPI: 1740887488
Provider Name (Legal Business Name): CHELSIE ORTIZ MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2020
Last Update Date: 10/06/2020
Certification Date: 10/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2651 NW 84TH AVE APT 104
MIAMI FL
33122-1570
US

IV. Provider business mailing address

2651 NW 84TH AVE APT 104
MIAMI FL
33122-1570
US

V. Phone/Fax

Practice location:
  • Phone: 352-672-1838
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number11009366
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: