Provider Demographics
NPI:1801208368
Name:ORTIZ, SARAH (PT)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17141 OCEAN HILL DR
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-3253
Mailing Address - Country:US
Mailing Address - Phone:904-806-4076
Mailing Address - Fax:
Practice Address - Street 1:177 HUNTINGTON AVE
Practice Address - Street 2:STE 1703
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-3153
Practice Address - Country:US
Practice Address - Phone:857-990-6111
Practice Address - Fax:857-576-0057
Is Sole Proprietor?:No
Enumeration Date:2014-06-02
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA25362225100000X
CA300905225100000X
FLPT29258225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL686675Medicare PIN