Provider Demographics
NPI:1609133016
Name:ROSARIO ORTIGAO, LLC
Entity Type:Organization
Organization Name:ROSARIO ORTIGAO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:ROSARIO
Authorized Official - Middle Name:C
Authorized Official - Last Name:ORTIGAO
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:407-628-1009
Mailing Address - Street 1:1850 LEE RD STE 313
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-2107
Mailing Address - Country:US
Mailing Address - Phone:407-628-1009
Mailing Address - Fax:
Practice Address - Street 1:1850 LEE RD STE 313
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-2107
Practice Address - Country:US
Practice Address - Phone:407-628-1009
Practice Address - Fax:407-628-3224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-23
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2329261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health