Provider Demographics
NPI:1083018493
Name:ORDONEZ, MIGUEL ANTONIO (MS, PA-C)
Entity Type:Individual
Prefix:
First Name:MIGUEL
Middle Name:ANTONIO
Last Name:ORDONEZ
Suffix:
Gender:M
Credentials:MS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5050 E GALBRAITH RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-2885
Mailing Address - Country:US
Mailing Address - Phone:513-891-2111
Mailing Address - Fax:513-891-2113
Practice Address - Street 1:5050 E GALBRAITH RD
Practice Address - Street 2:SUITE A
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2885
Practice Address - Country:US
Practice Address - Phone:513-891-2111
Practice Address - Fax:513-891-2113
Is Sole Proprietor?:No
Enumeration Date:2014-10-14
Last Update Date:2014-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.003928363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical