Individual
MR. RAFAEL NATHAN ORTIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BSW
Contact information
Practice address
315 N LAKEMONT AVE, WINTER PARK, FL 32792-3205
(407) 792-5534
Mailing address
315 N. LAKEMONT AVE, WINTER PARK, FL 32792
(305) 491-8693
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9999999999
—
FL
Enumeration date
07/30/2012
Last updated
07/30/2012
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