Provider Demographics
NPI:1255433264
Name:ORTIZ, JULIO (MD)
Entity type:Individual
Prefix:
First Name:JULIO
Middle Name:
Last Name:ORTIZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8420 W FLAGLER ST STE 120
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2045
Mailing Address - Country:US
Mailing Address - Phone:305-552-0109
Mailing Address - Fax:305-559-5300
Practice Address - Street 1:8420 W FLAGLER ST STE 120
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2045
Practice Address - Country:US
Practice Address - Phone:305-552-0109
Practice Address - Fax:305-559-5300
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0014656207RC0000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL051676700Medicaid
D85040Medicare UPIN
FL051676700Medicaid