MEDICARE: AMPARO ORTIZ

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	106S00000X	Behavior Technician	RBT-20-136419	FL

General Provider Information

NPI Number	:	1609482975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMPARO ORTIZ

Provider Business Mailing Address
First Line	:	16420 SW 109TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33157-2815
Country	:	US
Telephone Number	:	305-834-1450
Fax Number	:

Provider Business Practice Location Address
First Line	:	16420 SW 109TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33157-2815
Country	:	US
Telephone Number	:	305-834-1450
Fax Number	:

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

Provider Enumeration Date	:	09/21/2020
Last Update Date	:	09/21/2020

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Directions to “ AMPARO ORTIZ ” Practice Location

Language	Start Address	Practice Location

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