Provider Demographics
NPI:1992562037
Name:ORTIZ/ AJ SECURITY SOLUTIONS LLC, ANTONIO
Entity type:Individual
Prefix:
First Name:ANTONIO
Middle Name:
Last Name:ORTIZ/ AJ SECURITY SOLUTIONS LLC
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 1:7326 STATE ROUTE 19 UNIT 5404
Mailing Address - Street 2:
Mailing Address - City:MOUNT GILEAD
Mailing Address - State:OH
Mailing Address - Zip Code:43338-9349
Mailing Address - Country:US
Mailing Address - Phone:740-692-2811
Mailing Address - Fax:419-884-7598
Practice Address - Street 1:AJ SECURITY SOLUTIONS LLC
Practice Address - Street 2:7326 ST RT 19 UNIT 5404
Practice Address - City:MT GILEAD
Practice Address - State:OH
Practice Address - Zip Code:43338
Practice Address - Country:US
Practice Address - Phone:740-692-2811
Practice Address - Fax:419-884-7598
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH94054293374700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician