Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | PO3258 | FL |
NPI | 1154542512 |
---|---|
Provider Name | Julio Cesar Ortiz |
First Address | Boynton Beach, FL 33437-6166 |
Second Address | Boynton Beach, FL 33437-6166 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2007 |
Last Update Date | 06/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
007293100 | (05) | FL |