MEDICARE: DR. ERICA ORTIZ-PELLICER

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	101YM0800X	Mental Health Counselor	MH27037	FL

General Provider Information

NPI Number	:	1639033632
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERICA ORTIZ-PELLICER

Provider Business Mailing Address
First Line	:	15514 STONE HOUSE DR
Second Line	:
City	:	BROOKSVILLE
State	:	FL
Zip	:	34604-5850
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	15514 STONE HOUSE DR
Second Line	:
City	:	BROOKSVILLE
State	:	FL
Zip	:	34604-5850
Country	:	US
Telephone Number	:	813-995-7392
Fax Number	:

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

Provider Enumeration Date	:	12/13/2025
Last Update Date	:	06/01/2026

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