Provider Demographics
NPI:1770185662
Name:ORTIZ, ANGEL ARTURO (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:ANGEL
Middle Name:ARTURO
Last Name:ORTIZ
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:665 NW 103RD CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-4056
Mailing Address - Country:US
Mailing Address - Phone:786-303-0297
Mailing Address - Fax:
Practice Address - Street 1:2631 SW 27TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-2239
Practice Address - Country:US
Practice Address - Phone:305-396-9002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-15
Last Update Date:2020-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL36478225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist