Provider Demographics
NPI:1154501344
Name:ORTIZ, FRANCISCO (PA)
Entity Type:Individual
Prefix:MR
First Name:FRANCISCO
Middle Name:
Last Name:ORTIZ
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:747 LAWRENCE ST
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-2556
Mailing Address - Country:US
Mailing Address - Phone:440-453-2666
Mailing Address - Fax:
Practice Address - Street 1:970 E WASHINGTON ST
Practice Address - Street 2:STE 203
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-3332
Practice Address - Country:US
Practice Address - Phone:330-721-4955
Practice Address - Fax:330-721-4901
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-06
Last Update Date:2016-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.002659363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant