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Individual

JUAN F ORTIZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1250 SW 27TH AVENUE, SUITE 303, MIAMI, FL 33135
(305) 642-2300
(305) 642-2300
Mailing address
9320 FONTAINEBLEAU BLVD, APARTM 303, MIAMI, FL 33172
(305) 559-3925

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME0026252
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
058698600
FL
Enumeration date
12/15/2006
Last updated
07/08/2007
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