Provider Demographics
NPI:1134263684
Name:ORTIZ, WENDY JEAN (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:JEAN
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 N HORSE PRAIRIE RD
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34450-1885
Mailing Address - Country:US
Mailing Address - Phone:352-344-9265
Mailing Address - Fax:
Practice Address - Street 1:102 E HIGHLAND BLVD
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34452-4847
Practice Address - Country:US
Practice Address - Phone:352-341-1212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS24988183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist