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Individual

JOSE ANGEL ORTIZ MAZA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BMO

Contact information

Practice address
6501 NW 36TH ST STE 390, VIRGINIA GARDENS, FL 33166-6963
(305) 871-0920
Mailing address
2451 SW 138TH PL, MIAMI, FL 33175-6313
(305) 485-9093

Taxonomy

Speciality
Code
Description
License number
State
2471C3402X
Radiography Radiologic Technologist
Primary
BMO 65089
FL

Other

Enumeration date
11/08/2007
Last updated
11/08/2007
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