Individual
CARA BORTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
500 N WASHINGTON AVE STE 105, TITUSVILLE, FL 32796-2759
(321) 268-0267
(321) 268-3357
Mailing address
PO BOX 1137, MELBOURNE, FL 32902-1137
(321) 952-9696
(321) 952-7937
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY9600
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018686200
—
FL
Enumeration date
09/01/2016
Last updated
11/16/2017
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