Healthcare Provider Details

I. General information

NPI: 1235042748
Provider Name (Legal Business Name): ORTIZ MEDICAL SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4580 S EASTERN AVE STE 29B
LAS VEGAS NV
89119-6100
US

IV. Provider business mailing address

4580 S EASTERN AVE STE 29B
LAS VEGAS NV
89119-6100
US

V. Phone/Fax

Practice location:
  • Phone: 786-725-1341
  • Fax:
Mailing address:
  • Phone: 786-725-1341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JULIO R ORTIZ GONZALEZ
Title or Position: PROVIDER
Credential: APRN
Phone: 786-725-1341