David M. Bortnick, PHD. PSYD. PA

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

FLPY2065 Issued in FL

Legal business name

DAVID M. BORTNICK, PHD. PSYD. PA

Practice address

1130 SE 18TH Place
Ocala, FL 34471-5422

Phone

(352) 390-6656

Fax

(352) 390-8756

NPI assigned

Jan 24, 2011

Organization subpart

No

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

Authorized official

Name

Dr. David M. Bortnick, PHD., PSYD, PA

Title

Ceo

Phone

(352) 390-6656

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1295827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363305600000",
    "number": "1225333123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 SE 18TH PLACE",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344715422",
            "telephone_number": "352-390-6656",
            "fax_number": "352-390-8756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 SE 18TH PLACE",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344715422",
            "telephone_number": "352-390-6656",
            "fax_number": "352-390-8756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID M. BORTNICK, PHD. PSYD. PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-24",
        "last_updated": "2013-03-15",
        "status": "A",
        "authorized_official_last_name": "BORTNICK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "352-390-6656",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD., PSYD, PA"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "FLPY2065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Neuropsychologist in Ocala, FL
• Providers in Ocala, FL by specialty
• Clinical Neuropsychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2013; 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.