Healthcare Provider Details

I. General information

NPI: 1740293992
Provider Name (Legal Business Name): GISELA M. RAMOS ORTIZ M.A., OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 FORDHAM ROAD
VIRGINIA BEACH VA
23464
US

IV. Provider business mailing address

327 BARON BLVD
SUFFOLK VA
23435-2491
US

V. Phone/Fax

Practice location:
  • Phone: 757-361-3951
  • Fax: 757-361-3957
Mailing address:
  • Phone: 757-375-1256
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0119004172
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: