Provider Demographics
NPI:1154542512
Name:ORTIZ, JULIO CESAR (DPM)
Entity type:Individual
Prefix:
First Name:JULIO
Middle Name:CESAR
Last Name:ORTIZ
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7545 W BOYNTON BEACH BLVD
Mailing Address - Street 2:202
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-6166
Mailing Address - Country:US
Mailing Address - Phone:561-995-0229
Mailing Address - Fax:561-989-0775
Practice Address - Street 1:7545 W BOYNTON BEACH BLVD
Practice Address - Street 2:202
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-6166
Practice Address - Country:US
Practice Address - Phone:561-995-0229
Practice Address - Fax:561-989-0775
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3258213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL007293100Medicaid
FL007293100Medicaid