MEDICARE: PABLO SILVA ORTIZ MPSYC IN COUSELLING

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	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1609399070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PABLO SILVA ORTIZ MPSYC IN COUSELLING

Provider Business Mailing Address
First Line	:	3234 CANDLE RIDGE DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32822-3722
Country	:	US
Telephone Number	:	787-608-5353
Fax Number	:

Provider Business Practice Location Address
First Line	:	3234 CANDLE RIDGE DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32822-3722
Country	:	US
Telephone Number	:	787-608-5353
Fax Number	:

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

Provider Enumeration Date	:	07/18/2017
Last Update Date	:	07/21/2022

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