Provider Demographics
NPI:1821889791
Name:ALVAREZ ORTIZ, LIZ MASSIEL
Entity type:Individual
Prefix:
First Name:LIZ MASSIEL
Middle Name:
Last Name:ALVAREZ 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 1:3880 CATALINA ST
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32796-2211
Mailing Address - Country:US
Mailing Address - Phone:321-346-8450
Mailing Address - Fax:321-249-1105
Practice Address - Street 1:3880 CATALINA ST
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32796-2211
Practice Address - Country:US
Practice Address - Phone:321-346-8450
Practice Address - Fax:321-249-1105
Is Sole Proprietor?:No
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL25-434967106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician