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General NPI Number Information
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NPI Number | 1326438771
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Entity Type | Organization
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Legal Business Name | PEDRO L. ORTEGA MD PA
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Dates
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Enumeration Date | 01/23/2015
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Last Update Date | 01/23/2015
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Provider Practice Location Address
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Address Line | 3727 N GOLDENROD RD SUITE 106
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City | WINTER PARK
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State | FL
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Zip | 32792-8611
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Country | US
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Telephone | 407-478-0028
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Fax | 407-476-0297
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Provider Business Mailing Address
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Address Line | 3727 N GOLDENROD RD SUITE 106
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City | WINTER PARK
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State | FL
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Zip | 32792-8611
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Country | US
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Telephone | 407-478-0028
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Fax | 407-476-0297
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. PEDRO L ORTEGA
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Credential | MD
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Telephone | 407-478-0028
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME0075974
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License Number State | FL
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