Active NPI
Gloria M Reyes- Ortiz, PA
- Medical Physician Assistant
- Longwood, FL
National Provider Identifier
1922232065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA 9104944
- Practice address
- 225 W Highway 434
Suite 203
Longwood, FL 32750-4980 - Phone
- (407) 459-4360
- Fax
- (321) 316-4714
- NPI assigned
- May 4, 2009
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA 9104944 | FL | Primary |
Addresses
Primary practice location
225 W Highway 434
Suite 203
Longwood, FL 32750-4980
Mailing address
7301 Stonerock Cir
Suite 2
Orlando, FL 32819-8004
Phone (407) 351-1002
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PA 9104944 | Other | FL | PA-C LICENSE |
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA 9104944 | FL | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1241395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1446508800000",
"number": "1922232065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7301 STONEROCK CIR",
"address_2": "SUITE 2",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328198004",
"telephone_number": "407-351-1002",
"fax_number": "407-351-1119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 W HIGHWAY 434",
"address_2": "SUITE 203",
"city": "LONGWOOD",
"state": "FL",
"postal_code": "327504980",
"telephone_number": "407-459-4360",
"fax_number": "321-316-4714"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYES- ORTIZ",
"first_name": "GLORIA",
"middle_name": "M",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-05-04",
"last_updated": "2015-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "FL",
"license": "PA 9104944",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PA-C LICENSE",
"identifier": "PA 9104944",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Longwood, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.