Active NPI
Edert B. Ortiz, PA-C
- Physician Assistant
- Hollywood, FL
National Provider Identifier
1801096862
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA0002710
- Practice address
- 824 S Federal Hwy
Hollywood, FL 33020-5438 - Phone
- (954) 921-5553
- Fax
- (954) 921-5582
- NPI assigned
- Jul 18, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA0002710 | FL | Primary |
Addresses
Primary practice location
824 S Federal Hwy
Hollywood, FL 33020-5438
Mailing address
824 S Federal Hwy
Hollywood, FL 33020-5438
Phone (954) 921-5553
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA0002710 | FL | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184716800000",
"number": "1801096862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "824 S FEDERAL HWY",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330205438",
"telephone_number": "954-921-5553",
"fax_number": "954-921-5582"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "824 S FEDERAL HWY",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330205438",
"telephone_number": "954-921-5553",
"fax_number": "954-921-5582"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ORTIZ",
"first_name": "EDERT",
"middle_name": "B.",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-18",
"last_updated": "2007-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA0002710",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hollywood, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.