Basic Information
| Provider Information | |||||||||
| NPI: | 1467458109 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ORTIZ | ||||||||
| FirstName: | MARIA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | M.S. CCC-A | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5525 SW 86TH ST | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331438306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7862713674 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8940 N KENDALL DR | ||||||||
| Address2: | SUITE 504E | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331762148 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055956200 | ||||||||
| FaxNumber: | 3055984071 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2005 | ||||||||
| LastUpdateDate: | 04/16/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | Y | Speech, Language and Hearing Service Providers | Audiologist |
ID Information
| ID | Type | State | Issuer | Description | AY2746 | 01 | FL | STATE AUDIOLOGY LICENSE | OTHER |