Healthcare Provider Details

I. General information

NPI: 1346928090
Provider Name (Legal Business Name): CHRISTOPHER OTERO APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2023
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 S ORANGE AVE FL 2
ORLANDO FL
32806-2134
US

IV. Provider business mailing address

1400 S ORANGE AVE FL 2
ORLANDO FL
32806-2134
US

V. Phone/Fax

Practice location:
  • Phone: 321-841-2401
  • Fax: 321-843-6850
Mailing address:
  • Phone: 321-841-2401
  • Fax: 321-843-6850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN11027443
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number11027443
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: