Provider Demographics
NPI:1588399190
Name:PITTS, RORY
Entity type:Individual
Prefix:MR
First Name:RORY
Middle Name:
Last Name:PITTS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2881 N OAKLAND FOREST DR APT 303
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33309-6417
Mailing Address - Country:US
Mailing Address - Phone:614-286-1581
Mailing Address - Fax:
Practice Address - Street 1:2881 N OAKLAND FOREST DR APT 303
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33309-6417
Practice Address - Country:US
Practice Address - Phone:614-286-1581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH22352101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health