Provider Demographics
NPI:1912384280
Name:ORTIZ DE CHOUDENS, SARYLEINE (MD)
Entity type:Individual
Prefix:
First Name:SARYLEINE
Middle Name:
Last Name:ORTIZ DE CHOUDENS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1240 S OLD DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-7205
Mailing Address - Country:US
Mailing Address - Phone:561-263-4400
Mailing Address - Fax:561-263-4408
Practice Address - Street 1:1240 S OLD DIXIE HWY
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7205
Practice Address - Country:US
Practice Address - Phone:561-263-4400
Practice Address - Fax:561-263-4408
Is Sole Proprietor?:No
Enumeration Date:2015-05-06
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI71858-202085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1912384280Medicaid