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General NPI Number Information
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NPI Number | 1659621324
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Entity Type | Individual
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Provider Name | DALLY I RIOS-ORTEGA PSY.D
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Gender | Female
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Dates
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Enumeration Date | 09/10/2012
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Last Update Date | 07/31/2017
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Provider Practice Location Address
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Address Line | 10294 CAROLINE PARK DR
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City | ORLANDO
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State | FL
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Zip | 32832-5865
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Country | US
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Telephone | 804-519-2546
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Fax |
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Provider Business Mailing Address
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Address Line | 3855 OLD CANOE CREEK RD
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City | SAINT CLOUD
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State | FL
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Zip | 34769-6628
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Country | US
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Telephone | 407-957-2280
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY8383
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License Number State | FL
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