Healthcare Provider Details

I. General information

NPI: 1902254154
Provider Name (Legal Business Name): DANIEL LUIS ORTA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2016
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 E AJO WAY
TUCSON AZ
85713-6204
US

IV. Provider business mailing address

11561 SW 99TH ST
MIAMI FL
33176-2515
US

V. Phone/Fax

Practice location:
  • Phone: 520-874-4276
  • Fax:
Mailing address:
  • Phone: 786-662-7980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberR75745
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME142851
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME142851
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: