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NPI Code Detail

MEDICARE: DR. EDGARDO ONEILL ORTIZ-MENDEZ MD

MEDICARE: DR. EDGARDO ONEILL ORTIZ-MENDEZ MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program16829-1PR
2208D00000XGeneral Practice PhysicianACN1688FL
3208D00000XGeneral Practice Physician24170PR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1518542422
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EDGARDO ONEILL ORTIZ-MENDEZ MD
Provider Business Mailing Address
First Line : 425 W COLONIAL DR STE 303
Second Line :
City : ORLANDO
State : FL
Zip : 32804-6863
Country : US
Telephone Number : 210-630-2207
Fax Number :
Provider Business Practice Location Address
First Line : 1501 S SEMORAN BLVD
Second Line :
City : ORLANDO
State : FL
Zip : 32807-2919
Country : US
Telephone Number : 407-587-7552
Fax Number : 833-450-5422
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2021
Last Update Date : 03/18/2026

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