Healthcare Provider Details

I. General information

NPI: 1952542946
Provider Name (Legal Business Name): DESIREE ORTEGA L.M.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2009
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2851 S PALM AIRE DR APT 102
POMPANO BEACH FL
33069-4224
US

IV. Provider business mailing address

5435 NW 10TH CT #303
PLANTATION FL
33313-6478
US

V. Phone/Fax

Practice location:
  • Phone: 954-479-9840
  • Fax: 954-797-7077
Mailing address:
  • Phone: 954-797-7077
  • Fax: 954-797-7077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number31466
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: