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General NPI Number Information
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NPI Number | 1578699443
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Entity Type | Individual
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Provider Name | CARLOS WILFREDO ORTIZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 100 NW 170TH ST STE 102
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City | MIAMI
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State | FL
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Zip | 33169-5510
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Country | US
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Telephone | 305-685-5688
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. 1197
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City | GUAYAMA
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State | PR
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Zip | 00785-1197
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Country | US
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Telephone | 787-839-4150
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Fax | 787-839-6989
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 08340
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ACN412
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License Number State | FL
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