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General NPI Number Information
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NPI Number | 1295825263
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Entity Type | Individual
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Provider Name | JOSE OSCAR ORTIZ LMHC
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Gender | Male
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 2881 E OAKLAND PARK BLVD STE 304
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City | FORT LAUDERDALE
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State | FL
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Zip | 33306-1813
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Country | US
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Telephone | 754-300-0988
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Fax |
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Provider Business Mailing Address
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Address Line | 610 W LAS OLAS BLVD APT 1015
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City | FORT LAUDERDALE
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State | FL
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Zip | 33312-7129
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Country | US
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Telephone | 754-300-0988
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Fax | 954-462-3188
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH5212
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License Number State | FL
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