Provider Demographics
NPI:1265778450
Name:AURELIO ANTONIO ORTIZ MD PA
Entity type:Organization
Organization Name:AURELIO ANTONIO ORTIZ MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AURELIO
Authorized Official - Middle Name:
Authorized Official - Last Name:ANTONIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-381-0252
Mailing Address - Street 1:4894 NW 7TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2102
Mailing Address - Country:US
Mailing Address - Phone:305-381-0252
Mailing Address - Fax:305-982-8427
Practice Address - Street 1:4894 NW 7TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-2102
Practice Address - Country:US
Practice Address - Phone:305-381-0252
Practice Address - Fax:305-982-8427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-17
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center