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General NPI Number Information
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NPI Number | 1861767519
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Entity Type | Individual
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Provider Name | NYRMA NOEMI ORTIZ M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/14/2012
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Last Update Date | 03/14/2012
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Provider Practice Location Address
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Address Line | 2900 W PROSPECT RD
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City | TAMARAC
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State | FL
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Zip | 33309-2519
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Country | US
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Telephone | 954-731-5100
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Fax | 954-735-6624
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Provider Business Mailing Address
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Address Line | 4700 N STATE ROAD 7 STE 201
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33319-5804
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Country | US
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Telephone | 954-777-1617
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Fax | 954-495-3857
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | ME0072074
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME0072074
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | ME0072074
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License Number State | FL
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