Healthcare Provider Details

I. General information

NPI: 1154561199
Provider Name (Legal Business Name): FELIX ANGEL ORTIZ PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2009
Last Update Date: 03/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2843 SUMMER SWAN DR
ORLANDO FL
32825-7404
US

IV. Provider business mailing address

2843 SUMMER SWAN DR
ORLANDO FL
32825-7404
US

V. Phone/Fax

Practice location:
  • Phone: 407-382-1196
  • Fax: 407-382-1196
Mailing address:
  • Phone: 407-382-1196
  • Fax: 407-382-1196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPY7883
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: