Provider Demographics
NPI:1679867352
Name:ORTIZ, VERONICA (MD)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name: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 1:700 S WASHINGTON ST STE 330
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-4291
Mailing Address - Country:US
Mailing Address - Phone:703-528-8260
Mailing Address - Fax:703-528-8267
Practice Address - Street 1:700 S WASHINGTON ST STE 330
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-4291
Practice Address - Country:US
Practice Address - Phone:703-528-8260
Practice Address - Fax:703-528-8267
Is Sole Proprietor?:No
Enumeration Date:2011-05-31
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101255713207Q00000X, 208M00000X
PAMT199353207Q00000X
TN56623207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist