Healthcare Provider Details

I. General information

NPI: 1811084460
Provider Name (Legal Business Name): MARIA DE LOS ANGELES ORTEGA HERNANDEZ DNP, APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 05/22/2023
Certification Date: 05/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 GLADES RD
BOCA RATON FL
33431-6496
US

IV. Provider business mailing address

777 GLADES RD # AZ79
BOCA RATON FL
33431-6496
US

V. Phone/Fax

Practice location:
  • Phone: 561-297-0506
  • Fax:
Mailing address:
  • Phone: 561-297-0506
  • Fax: 561-297-0505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number2560022
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2560022
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: