Active NPI
Jorge Ortiz, DPT
- Physical Therapist
- Palm Bay, FL
National Provider Identifier
1124407796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT-30326
- Practice address
- 470 Malabar Rd SE
Ste 102
Palm Bay, FL 32909 - Phone
- (321) 802-9645
- NPI assigned
- May 28, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT-30326 | FL | Primary |
Addresses
Primary practice location
470 Malabar Rd SE
Ste 102
Palm Bay, FL 32909
Mailing address
470 Malabar Rd SE
Ste 102
Palm Bay, FL 32909
Phone (321) 802-9645
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT-30326 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475798400000",
"number": "1124407796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "470 MALABAR RD SE",
"address_2": "STE 102",
"city": "PALM BAY",
"state": "FL",
"postal_code": "32909",
"telephone_number": "321-802-9645"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "470 MALABAR RD SE",
"address_2": "STE 102",
"city": "PALM BAY",
"state": "FL",
"postal_code": "32909",
"telephone_number": "321-802-9645"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ORTIZ",
"first_name": "JORGE",
"name_prefix": "Mr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-05-28",
"last_updated": "2016-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT-30326",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Bay, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.