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General NPI Number Information
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NPI Number | 1861797284
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Entity Type | Individual
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Provider Name | EMMA R ORTEGON IMH
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Gender | Female
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Dates
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Enumeration Date | 01/14/2011
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Last Update Date | 01/14/2011
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Provider Practice Location Address
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Address Line | 4000 PONCE DE LEON BLVD STE 470
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City | CORAL GABLES
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State | FL
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Zip | 33146-1432
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Country | US
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Telephone | 305-777-0486
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Fax |
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Provider Business Mailing Address
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Address Line | 16468 SW 50TH TER
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City | MIAMI
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State | FL
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Zip | 33185-5160
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Country | US
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Telephone | 305-218-9117
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | IMH8403
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License Number State | FL
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