Provider Demographics
NPI:1477350346
Name:ORTIZ RODRIGUEZ, ADRIEL ALEJANDRO
Entity type:Individual
Prefix:
First Name:ADRIEL
Middle Name:ALEJANDRO
Last Name:ORTIZ RODRIGUEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 GRAHAM DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45066-1205
Mailing Address - Country:US
Mailing Address - Phone:937-856-1847
Mailing Address - Fax:
Practice Address - Street 1:15 GRAHAM DR
Practice Address - Street 2:
Practice Address - City:SPRINGBORO
Practice Address - State:OH
Practice Address - Zip Code:45066-1205
Practice Address - Country:US
Practice Address - Phone:937-856-1847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant