Provider Demographics
NPI:1790038933
Name:ORTIZ, SONIA IVETTE
Entity Type:Individual
Prefix:MS
First Name:SONIA
Middle Name:IVETTE
Last Name:ORTIZ
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 1:13136 SUMMERTON DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32824-6257
Mailing Address - Country:US
Mailing Address - Phone:321-236-2006
Mailing Address - Fax:321-250-7822
Practice Address - Street 1:600 N THACKER AVE
Practice Address - Street 2:SUITE D41
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4892
Practice Address - Country:US
Practice Address - Phone:321-236-2006
Practice Address - Fax:321-250-7822
Is Sole Proprietor?:No
Enumeration Date:2012-10-25
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101Y00000XBehavioral Health & Social Service ProvidersCounselor