Provider Demographics
NPI:1447792882
Name:ORTEZ, RODY JOSE
Entity Type:Individual
Prefix:
First Name:RODY
Middle Name:JOSE
Last Name:ORTEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 SW 63RD CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-3115
Mailing Address - Country:US
Mailing Address - Phone:561-294-1953
Mailing Address - Fax:305-901-1797
Practice Address - Street 1:45 SW 63RD CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-3115
Practice Address - Country:US
Practice Address - Phone:561-294-1953
Practice Address - Fax:305-901-1797
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-16
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician