MEDICARE: DR. ANGEL ARTURO ORTIZ PT, DPT

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	225100000X	Physical Therapist	36478	FL

General Provider Information

NPI Number	:	1770185662
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANGEL ARTURO ORTIZ PT, DPT

Provider Business Mailing Address
First Line	:	665 NW 103RD CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33172-4056
Country	:	US
Telephone Number	:	786-303-0297
Fax Number	:

Provider Business Practice Location Address
First Line	:	2631 SW 27TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33133-2239
Country	:	US
Telephone Number	:	305-396-9002
Fax Number	:

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

Provider Enumeration Date	:	11/15/2020
Last Update Date	:	11/15/2020

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