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General NPI Number Information
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NPI Number | 1093270456
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Entity Type | Individual
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Provider Name | ESTEBAN ORTEGA LAC
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Gender | Male
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Dates
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Enumeration Date | 02/09/2019
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Last Update Date | 08/17/2021
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Provider Practice Location Address
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Address Line | 7091 GRAND NATIONAL DR STE 102
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City | ORLANDO
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State | FL
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Zip | 32819-8382
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Country | US
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Telephone | 407-278-0680
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Fax | 407-604-6060
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Provider Business Mailing Address
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Address Line | 155 S COURT AVE UNIT 1905
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City | ORLANDO
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State | FL
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Zip | 32801-3214
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Country | US
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Telephone | 786-351-4737
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AP4028
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License Number State | FL
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