Healthcare Provider Details

I. General information

NPI: 1326501487
Provider Name (Legal Business Name): MAGDALYS ORTIZ AGCNS-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2019
Last Update Date: 01/30/2024
Certification Date: 01/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1881 UNIVERSITY DR
VIRGINIA BEACH VA
23453-8083
US

IV. Provider business mailing address

1407 HODGES FERRY RD
PORTSMOUTH VA
23701-1711
US

V. Phone/Fax

Practice location:
  • Phone: 757-683-4297
  • Fax: 757-683-5253
Mailing address:
  • Phone: 757-300-8092
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SG0600X
TaxonomyGerontology Clinical Nurse Specialist
License Number0024182307
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: