MEDICARE: JUSTINE OERTEL NP

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	363L00000X	Nurse Practitioner	11039116	FL

General Provider Information

NPI Number	:	1710879507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUSTINE OERTEL NP

Provider Business Mailing Address
First Line	:	3128 DARK SKY DR
Second Line	:
City	:	HARMONY
State	:	FL
Zip	:	34773-6000
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5833 S GOLDENROD RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32822-8777
Country	:	US
Telephone Number	:	407-810-8777
Fax Number	:

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

Provider Enumeration Date	:	07/16/2025
Last Update Date	:	07/16/2025

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