Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | DN17005 | FL |
Y | 213EG0000X | General Practice | DN17005 | FL |
NPI | 1003918111 |
---|---|
Provider Name | Ramon Ortiz-Roldan |
First Address | Tampa, FL 33607-1421 |
Second Address | Plant City, FL 33566-9413 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2006 |
Last Update Date | 18/11/2014 |