Provider Demographics
NPI:1710911243
Name:ORTIZ-TORRES, LUIS ARIEL (MD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:ARIEL
Last Name:ORTIZ-TORRES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14690 SPRING HILL DR
Mailing Address - Street 2:STE 101 ATTN:CREDENTIALING
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-8102
Mailing Address - Country:US
Mailing Address - Phone:352-799-0046
Mailing Address - Fax:352-606-2857
Practice Address - Street 1:5350 SPRING HILL DR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-4562
Practice Address - Country:US
Practice Address - Phone:352-688-8116
Practice Address - Fax:352-686-9477
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13942208D00000X
FLACN563208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR14108-5OtherASSMCA LICENSE
PR13942OtherSTATE MEDICAL LICENSE
FLACN 563OtherFLORIDA TEMPORARY ACN LICENSE
FLACN 563OtherFLORIDA TEMPORARY ACN LICENSE
PRBO7411490OtherDEA
FLID058WMedicare PIN
FLACN 563OtherFLORIDA TEMPORARY ACN LICENSE
FLID058XMedicare PIN
FLID058VMedicare PIN