Healthcare Provider Details

I. General information

NPI: 1558298059
Provider Name (Legal Business Name): ERNESTO JOSE OTERO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 NW 17TH ST
MIAMI FL
33136-1134
US

IV. Provider business mailing address

900 NW 17TH ST
MIAMI FL
33136-1119
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-2020
  • Fax: 305-326-6365
Mailing address:
  • Phone: 305-243-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMFC1999
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207WX0120X
TaxonomyCornea and External Diseases Specialist Physician
License NumberMFC1999
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: