Individual provider Active NPI

Mextli Lermont-Ortiz, PA-C

  • Medical Physician Assistant
  • Tampa, FL
National Provider Identifier
1508095175
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9105035 Issued in FL
Practice address
6646 Gunn Hwy
Tampa, FL 33625-4055
Phone
(813) 788-1400
Fax
(813) 788-7691
NPI assigned
Jul 4, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9105035 FL Primary

Addresses

Primary practice location

6646 Gunn Hwy
Tampa, FL 33625-4055

Mailing address

2477 Bruce B Downs Blvd
Wesley Chapel, FL 33544-9213
Phone (813) 788-1400

Other identifiers 1

IdentifierTypeStateIssuer
PA9105035OtherFLMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090811000663 FL Practitioner - Physician Assistant 0345394235 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9105035FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
PHVC Ekg LLC Past Accepting new patients

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1246665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1508095175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2477 BRUCE B DOWNS BLVD",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335449213",
            "telephone_number": "813-788-1400",
            "fax_number": "813-788-7691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6646 GUNN HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336254055",
            "telephone_number": "813-788-1400",
            "fax_number": "813-788-7691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LERMONT-ORTIZ",
        "first_name": "MEXTLI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-04",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9105035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "PA9105035",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.