Active NPI
Carmen Yadira Ortiz
- Developmental Disabilities Clinic/Center
- Saint Cloud, FL
National Provider Identifier
1265900641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Disabilities Clinic/Center
- Practice address
- 5263 Villa Rosa Ave
Saint Cloud, FL 34771-7849 - Phone
- (787) 690-6104
- NPI assigned
- Nov 5, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | |||
| Developmental Disabilities Clinic/Center | 261QD1600X | Primary |
Addresses
Primary practice location
5263 Villa Rosa Ave
Saint Cloud, FL 34771-7849
Mailing address
2108 Walden Park Cir Apt 203
Kissimmee, FL 34744-6310
Phone (787) 690-6104
Other practice location 1
3201 Budinger Ave
Saint Cloud, FL 34769-7203
Phone (407) 891-3054
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1541376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551916800000",
"number": "1265900641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2108 WALDEN PARK CIR APT 203",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347446310",
"telephone_number": "787-690-6104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5263 VILLA ROSA AVE",
"city": "SAINT CLOUD",
"state": "FL",
"postal_code": "347717849",
"telephone_number": "787-690-6104"
}
],
"practiceLocations": [
{
"address_1": "3201 Budinger Ave",
"address_purpose": "LOCATION",
"city": "Saint Cloud",
"state": "FL",
"postal_code": "347697203",
"country_code": "US",
"telephone_number": "407-891-3054",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ORTIZ",
"first_name": "CARMEN",
"middle_name": "YADIRA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-11-05",
"last_updated": "2019-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "261QM0801X",
"taxonomy_group": "",
"desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QD1600X",
"taxonomy_group": "",
"desc": "Clinic/Center, Developmental Disabilities",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Cloud, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.