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General NPI Number Information
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NPI Number | 1013280395
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Entity Type | Individual
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Provider Name | MELISSA ORTIZ LMT, PTA
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Gender | Female
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Dates
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Enumeration Date | 02/16/2012
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Last Update Date | 03/01/2022
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Provider Practice Location Address
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Address Line | 2605 BUCKHORN PRESERVE BLVD
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City | VALRICO
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State | FL
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Zip | 33596
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Country | US
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Telephone | 813-412-0278
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Fax |
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Provider Business Mailing Address
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Address Line | 2605 BUCKHORN PRESERVE BLVD
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City | VALRICO
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State | FL
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Zip | 33596
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Country | US
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Telephone | 813-412-0278
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175L00000X
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Taxonomy Name | Homeopath
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License Number | MA 53136
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 53136
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 25408
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License Number State | FL
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