Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | MA 53136 | FL |
NPI | 1013280395 |
---|---|
Provider Name | Melissa Ortiz |
First Address | Valrico, FL 33596 |
Second Address | Valrico, FL 33596 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2012 |
Last Update Date | 16/02/2012 |