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General NPI Number Information
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NPI Number | 1861470312
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Entity Type | Individual
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Provider Name | MARCOS R ORTEGA M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/05/2006
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Last Update Date | 08/30/2019
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Provider Practice Location Address
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Address Line | 5080 BAYOU BLVD
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City | PENSACOLA
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State | FL
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Zip | 32503-2522
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Country | US
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Telephone | 850-477-4074
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Fax | 850-476-9234
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Provider Business Mailing Address
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Address Line | 5080 BAYOU BLVD
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City | PENSACOLA
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State | FL
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Zip | 32503-2522
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Country | US
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Telephone | 850-477-4074
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Fax | 850-476-9234
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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 | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | ME84738
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License Number State | FL
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