Provider Demographics
NPI:1316405301
Name:ORTEGA, KATIE
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:ORTEGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9416 SW 32ND TER APT 1
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34476-7672
Mailing Address - Country:US
Mailing Address - Phone:352-875-2586
Mailing Address - Fax:
Practice Address - Street 1:10252 SE US HIGHWAY 441
Practice Address - Street 2:UNITS 3,4,5
Practice Address - City:BELLEVIEW
Practice Address - State:FL
Practice Address - Zip Code:34420
Practice Address - Country:US
Practice Address - Phone:352-559-2539
Practice Address - Fax:352-547-5787
Is Sole Proprietor?:No
Enumeration Date:2019-03-08
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician