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NPI Code Detail

MEDICARE: MELISSA EVELYN ORTEGA

MEDICARE: MELISSA EVELYN 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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1912770819
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA EVELYN ORTEGA
Provider Business Mailing Address
First Line : 930 NOLAN WAY
Second Line :
City : CHULA VISTA
State : CA
Zip : 91911-2408
Country : US
Telephone Number : 619-799-8645
Fax Number :
Provider Business Practice Location Address
First Line : 10004 N DALE MABRY HWY
Second Line :
City : TAMPA
State : FL
Zip : 33618-4494
Country : US
Telephone Number : 888-880-9270
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2023
Last Update Date : 11/01/2023

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Directions to “ MELISSA EVELYN ORTEGA ” Practice Location

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