Provider Demographics
NPI:1982242566
Name:ORTIZ, ERVING
Entity type:Individual
Prefix:
First Name:ERVING
Middle Name:
Last Name:ORTIZ
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 1:1010 N HORSE PRAIRIE RD
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34450-1885
Mailing Address - Country:US
Mailing Address - Phone:352-344-9265
Mailing Address - Fax:352-753-5372
Practice Address - Street 1:2500 BURNSED BLVD
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32163-2704
Practice Address - Country:US
Practice Address - Phone:352-753-7476
Practice Address - Fax:352-753-5372
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-14
Last Update Date:2019-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS338471835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care