MEDICARE: MS. DESIREE ORTEGA L.M.T.

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	225200000X	Physical Therapy Assistant	31466	FL

General Provider Information

NPI Number	:	1952542946
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DESIREE ORTEGA L.M.T.

Provider Business Mailing Address
First Line	:	5435 NW 10TH CT
Second Line	:	#303
City	:	PLANTATION
State	:	FL
Zip	:	33313-6478
Country	:	US
Telephone Number	:	954-797-7077
Fax Number	:	954-797-7077

Provider Business Practice Location Address
First Line	:	2851 S PALM AIRE DR APT 102
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33069-4224
Country	:	US
Telephone Number	:	954-479-9840
Fax Number	:	954-797-7077

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

Provider Enumeration Date	:	03/20/2009
Last Update Date	:	06/06/2026

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