Individual provider Active NPI

Carmen Yadira Ortiz

  • Developmental Disabilities Clinic/Center
  • Saint Cloud, FL
National Provider Identifier
1265900641
Registry record updated Mar 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
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

Updated by the provider on Mar 7, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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.

Verify at the official NPI Registry.