Provider Demographics
NPI:1730109455
Name:ORTIZ, JOSE D (MD)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:D
Last Name:ORTIZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10701 EAST BLVD
Mailing Address - Street 2:CARDIOLOGY SECTION MAIL SYMBOL 111(W)
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-1702
Mailing Address - Country:US
Mailing Address - Phone:216-791-3800
Mailing Address - Fax:216-421-3066
Practice Address - Street 1:10701 EAST BLVD
Practice Address - Street 2:CARDIOLOGY SECTION MAIL SYMBOL 111(W)
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1702
Practice Address - Country:US
Practice Address - Phone:216-791-3800
Practice Address - Fax:216-421-3066
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-070454207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00258753OtherRAILROAD MEDICARE
OH000000221206OtherUNISON
000000503653OtherANTHEM
OH2136763Medicaid
OHP00358823OtherRAILROAD MEDICARE
OH363895OtherWELLCARE
OH741759OtherBUCKEYE
OH7667009OtherAETNA
OH7667009OtherAETNA
OH741759OtherBUCKEYE
OHP00358823OtherRAILROAD MEDICARE