Provider Demographics
NPI:1639830045
Name:ORTIZ RODRIGUEZ, NATALIA
Entity Type:Individual
Prefix:
First Name:NATALIA
Middle Name:
Last Name:ORTIZ RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2604 SW 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33914-4107
Mailing Address - Country:US
Mailing Address - Phone:239-850-6263
Mailing Address - Fax:
Practice Address - Street 1:26731 DUBLIN WOODS CIR STE 2
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-7271
Practice Address - Country:US
Practice Address - Phone:239-200-7248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-07
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13771111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor