Myddiam Ortiz, PTA

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

PTA11430 Issued in FL

Practice address

3651 W Waters Ave
Tampa, FL 33614-2783

Phone

(813) 932-5119

NPI assigned

May 13, 2010

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1273708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273708800000",
    "number": "1194043273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7517 CONNECTICUT DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336192033",
            "telephone_number": "813-770-7553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3651 W WATERS AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336142783",
            "telephone_number": "813-932-5119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ",
        "first_name": "MYDDIAM",
        "name_prefix": "Ms.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-13",
        "last_updated": "2010-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "FL",
            "license": "PTA11430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MO5000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Juan Felipe Ortiz, M.D
• Luis Ortiz, OD
• Luis Andres Ortiz, MD
• Maria D Ortiz, SOCIAL WORKER
• Marissa Rose Ortiz, PA-C
• Priscilla Ortiz
• Ramon F Ortiz, DMD, MS
• Blair Nichole Ortman, BCBA
• Catherine Ortner, DO
• Autumn Orville, PTA

• Physical Therapy Clinic/Center in Tampa, FL
• Providers in Tampa, FL by specialty
• Physical Therapy Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.