Provider Demographics
NPI:1962424739
Name:ORTIZ, RAMON F (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:RAMON
Middle Name:F
Last Name:ORTIZ
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5706 BENJAMIN CENTER DR STE 103
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-5262
Mailing Address - Country:US
Mailing Address - Phone:813-288-1999
Mailing Address - Fax:813-434-2325
Practice Address - Street 1:5706 BENJAMIN CENTER DR STE 103
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-5262
Practice Address - Country:US
Practice Address - Phone:813-288-1999
Practice Address - Fax:813-434-2325
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN78731223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice