Provider Demographics
NPI:1114569431
Name:ORTIZ, DONNA P (APRN)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:P
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 917770
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:265 E ROLLINS ST STE 10000
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-5502
Practice Address - Country:US
Practice Address - Phone:407-303-9921
Practice Address - Fax:407-303-8998
Is Sole Proprietor?:No
Enumeration Date:2019-10-09
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11004462363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL105681100Medicaid
FLZFX8POtherBLUE CROSS BLUE SHIELD