MEDICARE: ALEX ORTIZ FNP-BC

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	207Q00000X	Family Medicine Physician	319305	AZ

General Provider Information

NPI Number	:	1538021282
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEX ORTIZ FNP-BC

Provider Business Mailing Address
First Line	:	2760 W PEORIA AVE # 1110
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85029-5202
Country	:	US
Telephone Number	:	215-436-4487
Fax Number	:

Provider Business Practice Location Address
First Line	:	2760 W PEORIA AVE # 1110
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85029-5202
Country	:	US
Telephone Number	:	215-436-4487
Fax Number	:

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

Provider Enumeration Date	:	12/02/2025
Last Update Date	:	12/02/2025

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