MEDICARE: MICHAEL ORTEGA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SP-4385	NV

General Provider Information

NPI Number	:	1093673790
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL ORTEGA

Provider Business Mailing Address
First Line	:	1846 N JONES BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89108-1643
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8826 S EASTERN AVE STE 115
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-4826
Country	:	US
Telephone Number	:	702-360-1137
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

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Directions to “ MICHAEL ORTEGA ” Practice Location

Language	Start Address	Practice Location

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