Provider Demographics
NPI:1184157521
Name:J. OSCAR ORTIZ, P.A.
Entity type:Organization
Organization Name:J. OSCAR ORTIZ, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DPS
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:OSCAR
Authorized Official - Last Name:ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:305-332-3209
Mailing Address - Street 1:610 W LAS OLAS BLVD
Mailing Address - Street 2:APT 1015
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-7119
Mailing Address - Country:US
Mailing Address - Phone:305-332-3209
Mailing Address - Fax:
Practice Address - Street 1:2881 E OAKLAND PARK BLVD
Practice Address - Street 2:SUITE 304
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33306-1813
Practice Address - Country:US
Practice Address - Phone:305-332-3209
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-04
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH5212101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH5212OtherDEPT OF HEALTH MQA