Provider Demographics
NPI:1659148716
Name:ORTIZ, JANASIA (BCABA)
Entity type:Individual
Prefix:
First Name:JANASIA
Middle Name:
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5098 RAIN SHADOW DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34772-6360
Mailing Address - Country:US
Mailing Address - Phone:786-216-2183
Mailing Address - Fax:
Practice Address - Street 1:1203 FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769-3721
Practice Address - Country:US
Practice Address - Phone:407-243-8171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-08
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-25-16455106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst