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General NPI Number Information
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NPI Number | 1992948434
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Entity Type | Individual
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Provider Name | ENRIQUE J ORTIZ GUZMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/14/2009
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Last Update Date | 05/15/2015
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Provider Practice Location Address
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Address Line | 602 US HIGHWAY 17 92 N
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City | HAINES CITY
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State | FL
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Zip | 33844-9461
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Country | US
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Telephone | 863-858-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 13784 BECKMAN DR.
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City | WINDERMERE
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State | FL
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Zip | 34786
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Country | US
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Telephone | 787-245-1327
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 17458
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License Number State | PR
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