MEDICARE: DR. FELIX ANGEL ORTIZ PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103G00000X	Clinical Neuropsychologist	PY7883	FL

General Provider Information

NPI Number	:	1154561199
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FELIX ANGEL ORTIZ PSY.D.

Provider Business Mailing Address
First Line	:	2843 SUMMER SWAN DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32825-7404
Country	:	US
Telephone Number	:	407-382-1196
Fax Number	:	407-382-1196

Provider Business Practice Location Address
First Line	:	2843 SUMMER SWAN DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32825-7404
Country	:	US
Telephone Number	:	407-382-1196
Fax Number	:	407-382-1196

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2009
Last Update Date	:	03/04/2009

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