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General NPI Number Information
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NPI Number | 1821557851
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Entity Type | Individual
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Provider Name | MARIA ORTIZ DDS
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Gender | Female
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Dates
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Enumeration Date | 03/19/2019
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Last Update Date | 02/16/2023
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Provider Practice Location Address
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Address Line | 2410 FL-50 STE A
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City | CLERMONT
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State | FL
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Zip | 34711
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Country | US
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Telephone | 954-397-6709
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Fax |
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Provider Business Mailing Address
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Address Line | 2410 E HIGHWAY 50 STE A
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City | CLERMONT
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State | FL
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Zip | 34711-6020
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Country | US
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Telephone | 352-678-6506
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 25793
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License Number State | FL
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