Provider Demographics
NPI:1528207826
Name:OUTDOOR PRODUCT SOLUTIONS INC
Entity Type:Organization
Organization Name:OUTDOOR PRODUCT SOLUTIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:ORTIGOZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-326-6220
Mailing Address - Street 1:3101 SW 34TH AVE STE 905-411
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-7447
Mailing Address - Country:US
Mailing Address - Phone:786-326-6220
Mailing Address - Fax:
Practice Address - Street 1:3101 SW 34TH AVE STE 905-411
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-7447
Practice Address - Country:US
Practice Address - Phone:786-326-6220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-10
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service