Provider Demographics
NPI:1255608055
Name:ORTIZ, MARIA IVETTE
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:IVETTE
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6762 BEECH DR
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80004-2058
Mailing Address - Country:US
Mailing Address - Phone:303-582-6080
Mailing Address - Fax:
Practice Address - Street 1:2215 NW CACHE RD STE 107
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-5258
Practice Address - Country:US
Practice Address - Phone:580-351-9998
Practice Address - Fax:580-351-9898
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-22
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator