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NPI Code Detail

MEDICARE: SORANGEL ORTIZ RODRIGUEZ APRN

MEDICARE: SORANGEL ORTIZ RODRIGUEZ APRN
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
1163WG0000XGeneral Practice Registered NurseRN9514707FL
2363L00000XNurse Practitioner11024814FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
19514707OTHERFLREGISTERED NURSE
211024814OTHERFLFNP LICENSE

General Provider Information

NPI Number : 1912604695
Entity Type Code : Individual
Provider Name (Legal Business Name) : SORANGEL ORTIZ RODRIGUEZ APRN
Provider Business Mailing Address
First Line : 325 CLYDE MORRIS BLVD STE 340
Second Line :
City : ORMOND BEACH
State : FL
Zip : 32174-3199
Country : US
Telephone Number : 386-615-8971
Fax Number :
Provider Business Practice Location Address
First Line : 360 DOUGLAS AVE
Second Line :
City : ALTAMONTE SPRINGS
State : FL
Zip : 32714-3335
Country : US
Telephone Number : 850-304-7986
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2023
Last Update Date : 02/12/2026

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