Provider Demographics
NPI:1871225425
Name:ORTIZ, EYLEEN
Entity Type:Individual
Prefix:DR
First Name:EYLEEN
Middle Name:
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 1:1 BOWEN DR STE 1
Mailing Address - Street 2:
Mailing Address - City:KEY LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33037-2902
Mailing Address - Country:US
Mailing Address - Phone:305-704-0313
Mailing Address - Fax:
Practice Address - Street 1:220 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-6034
Practice Address - Country:US
Practice Address - Phone:305-704-0506
Practice Address - Fax:786-901-8353
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-30
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst