Healthcare Provider Details

I. General information

NPI: 1750229415
Provider Name (Legal Business Name): ASHLEY OTERO L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1551 SANDSPUR RD STE 101
MAITLAND FL
32751-6138
US

IV. Provider business mailing address

224 LIVE OAK LN
ALTAMONTE SPRINGS FL
32714-5831
US

V. Phone/Fax

Practice location:
  • Phone: 321-926-2997
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP3364
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: