Healthcare Provider Details

I. General information

NPI: 1497733208
Provider Name (Legal Business Name): FELIX R. ORTEGA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2006
Last Update Date: 10/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2124 SW 20TH PL
OCALA FL
34471-0854
US

IV. Provider business mailing address

5220 BELFORT RD SUITE 130
JACKSONVILLE FL
32256-6017
US

V. Phone/Fax

Practice location:
  • Phone: 352-237-2960
  • Fax:
Mailing address:
  • Phone: 904-446-3451
  • Fax: 904-446-3013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number228276-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: