Provider Demographics
NPI:1467596536
Name:ORTIZ, CARLOS RAMON (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:RAMON
Last Name:ORTIZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1687 BUCKEYE FALLS WAY
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32824-4347
Mailing Address - Country:US
Mailing Address - Phone:407-437-8261
Mailing Address - Fax:
Practice Address - Street 1:1687 BUCKEYE FALLS WAY
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32824-4347
Practice Address - Country:US
Practice Address - Phone:407-437-8261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301113536208D00000X
FLACN883208D00000X
PR14637208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice