Provider Demographics
NPI:1467439174
Name:ORTIZ, NARMO LUIS JR (DPM)
Entity Type:Individual
Prefix:DR
First Name:NARMO
Middle Name:LUIS
Last Name:ORTIZ
Suffix:JR
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 PATTERSON RD STE 3
Mailing Address - Street 2:
Mailing Address - City:HAINES CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33844-6261
Mailing Address - Country:US
Mailing Address - Phone:863-422-2356
Mailing Address - Fax:863-547-8903
Practice Address - Street 1:280 PATTERSON RD STE 3
Practice Address - Street 2:
Practice Address - City:HAINES CITY
Practice Address - State:FL
Practice Address - Zip Code:33844-6261
Practice Address - Country:US
Practice Address - Phone:863-422-2356
Practice Address - Fax:863-547-8903
Is Sole Proprietor?:No
Enumeration Date:2005-12-23
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA762213ES0103X
FLPO2522213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL390304400Medicaid
FL65420AMedicare ID - Type Unspecified
FLU61608Medicare UPIN