Provider Demographics
NPI:1205486255
Name:PIZARRO ORTIZ, MARY LIZ (CASE MANAGER)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:LIZ
Last Name:PIZARRO ORTIZ
Suffix:
Gender:F
Credentials:CASE MANAGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 W VINE ST
Mailing Address - Street 2:SUITE 278
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741
Mailing Address - Country:US
Mailing Address - Phone:321-900-5786
Mailing Address - Fax:
Practice Address - Street 1:3501 W VINE ST STE 278
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4673
Practice Address - Country:US
Practice Address - Phone:321-900-5786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-11
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator