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General NPI Number Information
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NPI Number | 1659662914
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Entity Type | Organization
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Legal Business Name | CLEOPATRA ORTIZ, MD, PA
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Dates
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Enumeration Date | 04/21/2011
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Last Update Date | 04/21/2011
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Provider Practice Location Address
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Address Line | 1639 FORUM PL STE 7
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-2330
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Country | US
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Telephone | 561-248-5920
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1465
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City | WEST PALM BEACH
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State | FL
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Zip | 33402-1465
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Country | US
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Telephone | 561-248-5920
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CLEOPATRA ORTIZ
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Credential | MD
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Telephone | 561-248-5920
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | ME 0081266
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License Number State | FL
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