MEDICARE: VICTORIA ORREGO CBHMCM

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	104100000X	Social Worker

General Provider Information

NPI Number	:	1306514971
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA ORREGO CBHMCM

Provider Business Mailing Address
First Line	:	3203 PORT ROYALE DR S APT L
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33308-7870
Country	:	US
Telephone Number	:	954-709-5972
Fax Number	:

Provider Business Practice Location Address
First Line	:	3203 PORT ROYALE DR S APT L
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33308-7870
Country	:	US
Telephone Number	:	954-709-5972
Fax Number	:

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

Provider Enumeration Date	:	08/31/2021
Last Update Date	:	08/31/2021

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Directions to “ VICTORIA ORREGO CBHMCM” Practice Location

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