Provider Demographics
NPI:1285081943
Name:ORTIZ-MORALES, JESUS (DC)
Entity type:Individual
Prefix:DR
First Name:JESUS
Middle Name:
Last Name:ORTIZ-MORALES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:397 TUSCANY CHASE DR
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32117-5521
Mailing Address - Country:US
Mailing Address - Phone:787-402-9014
Mailing Address - Fax:
Practice Address - Street 1:877 S ORANGE BLOSSOM TRL
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-6522
Practice Address - Country:US
Practice Address - Phone:407-889-3223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-23
Last Update Date:2018-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11523111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor