Provider Demographics
NPI:1992012447
Name:SANDRA GARCIA-ORTIZ DPM PA
Entity Type:Organization
Organization Name:SANDRA GARCIA-ORTIZ DPM PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRY
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA-ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:305-785-0106
Mailing Address - Street 1:11435 SW 133RD CT APT 3
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-7984
Mailing Address - Country:US
Mailing Address - Phone:305-785-0106
Mailing Address - Fax:305-383-6195
Practice Address - Street 1:250 W 49TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3714
Practice Address - Country:US
Practice Address - Phone:305-887-1403
Practice Address - Fax:305-887-0125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-04
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3370213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty