Provider Demographics
NPI:1083756068
Name:ORTIZ, ANGEL L (BS, CVT,RDMS)
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:L
Last Name:ORTIZ
Suffix:
Gender:M
Credentials:BS, CVT,RDMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7990 SW 117TH AVE
Mailing Address - Street 2:SUITE 113
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196
Mailing Address - Country:US
Mailing Address - Phone:305-274-3707
Mailing Address - Fax:305-274-3720
Practice Address - Street 1:7990 SW 117TH AVE
Practice Address - Street 2:SUITE 113
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196
Practice Address - Country:US
Practice Address - Phone:305-274-3707
Practice Address - Fax:305-274-3720
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL415632471V0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular Sonography