Provider Demographics
NPI:1679390322
Name:POSADA ORTIZ, DAVID MANUEL (SA-C)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:MANUEL
Last Name:POSADA ORTIZ
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2971 WHITE CEDAR CIR
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-7626
Mailing Address - Country:US
Mailing Address - Phone:689-215-2219
Mailing Address - Fax:
Practice Address - Street 1:2971 WHITE CEDAR CIR
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-7626
Practice Address - Country:US
Practice Address - Phone:689-215-2219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24-420246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant