Provider Demographics
NPI:1588848386
Name:YOUNG ORTIZ, CAROLINA (MD)
Entity Type:Individual
Prefix:
First Name:CAROLINA
Middle Name:
Last Name:YOUNG ORTIZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2590 GOLDEN GATE PARKWAY
Mailing Address - Street 2:SUITE 104
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34105
Mailing Address - Country:US
Mailing Address - Phone:230-333-8809
Mailing Address - Fax:
Practice Address - Street 1:2590 GOLDEN GATE PKWY STE 104
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34105-3209
Practice Address - Country:US
Practice Address - Phone:239-333-8809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-28
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY290973-01207Q00000X
FLME117731174400000X
CA148865207Q00000X
WAMD61096651207Q00000X
PAMD459430207Q00000X
VA0101270807207Q00000X
TXN7377207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No174400000XOther Service ProvidersSpecialist