Provider Demographics
NPI:1033924972
Name:ORTIZ SANCHEZ, JUAN DAVID (LPN)
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:DAVID
Last Name:ORTIZ SANCHEZ
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7830 FARRAGUT ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-2522
Mailing Address - Country:US
Mailing Address - Phone:954-802-7595
Mailing Address - Fax:
Practice Address - Street 1:7830 FARRAGUT ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-2522
Practice Address - Country:US
Practice Address - Phone:954-802-7595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5213142164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse