Provider Demographics
NPI:1174591903
Name:ORTIZ, HECTOR LUIS II
Entity type:Individual
Prefix:MR
First Name:HECTOR
Middle Name:LUIS
Last Name:ORTIZ
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5959 FORT CAROLINE RD
Mailing Address - Street 2:APT 3104
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32277
Mailing Address - Country:US
Mailing Address - Phone:904-270-6293
Mailing Address - Fax:
Practice Address - Street 1:5959 FORT CAROLINE RD
Practice Address - Street 2:APT 3104
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32277-1884
Practice Address - Country:US
Practice Address - Phone:904-270-6293
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman