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General NPI Number Information
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NPI Number | 1396109898
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Entity Type | Individual
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Provider Name | ANGELICA GABRIELA ORTIZ M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/11/2016
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 17900 NW 5TH ST STE 204
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City | PEMBROKE PINES
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State | FL
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Zip | 33029-2809
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Country | US
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Telephone | 305-222-7082
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Fax |
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Provider Business Mailing Address
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Address Line | 17900 NW 5TH ST STE 204
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City | PEMBROKE PINES
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State | FL
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Zip | 33029-2809
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Country | US
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Telephone | 305-222-7082
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | ME150839
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License Number State | FL
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