Healthcare Provider Details

I. General information

NPI: 1912678137
Provider Name (Legal Business Name): IDELYS GARCIA ORTIZ FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2021
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8199 N UNIVERSITY DR
TAMARAC FL
33321-1744
US

IV. Provider business mailing address

8333 NW 53RD ST FL 6
DORAL FL
33166-4783
US

V. Phone/Fax

Practice location:
  • Phone: 954-591-8034
  • Fax: 954-800-4082
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11013577
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: