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General NPI Number Information
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NPI Number | 1952581837
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Entity Type | Individual
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Provider Name | JOSE ANGEL ORTIZ MAZA BMO
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Gender | Male
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Dates
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Enumeration Date | 11/08/2007
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Last Update Date | 11/08/2007
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Provider Practice Location Address
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Address Line | 6501 NW 36TH ST STE 390
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City | VIRGINIA GARDENS
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State | FL
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Zip | 33166-6963
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Country | US
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Telephone | 305-871-0920
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Fax |
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Provider Business Mailing Address
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Address Line | 2451 SW 138TH PL
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City | MIAMI
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State | FL
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Zip | 33175-6313
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Country | US
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Telephone | 305-485-9093
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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 | 2471C3402X
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Taxonomy Name | Radiography Radiologic Technologist
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License Number | BMO 65089
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License Number State | FL
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