Provider Demographics
NPI:1952324253
Name:ORTIZ-BECHER, MELISSA (PY)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:
Last Name:ORTIZ-BECHER
Suffix:
Gender:F
Credentials:PY
Other - Prefix:MS
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:ORTIZ-MATOS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD, LMHC
Mailing Address - Street 1:11419 MILLPOND GREENS DR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33473-7803
Mailing Address - Country:US
Mailing Address - Phone:561-906-7764
Mailing Address - Fax:561-736-5178
Practice Address - Street 1:7301 WEST PALMETTO PARK RD.
Practice Address - Street 2:SUITE 104 B
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3455
Practice Address - Country:US
Practice Address - Phone:561-368-9940
Practice Address - Fax:561-736-5178
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8182101YM0800X
FLPY7318103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPY7318OtherLICENSE
FLPY7318OtherLICENSE
FLAK007ZMedicare PIN