Provider Demographics
NPI:1083202949
Name:OROSTEGUI, IUTZI TAHIANA (MD)
Entity Type:Individual
Prefix:
First Name:IUTZI
Middle Name:TAHIANA
Last Name:OROSTEGUI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8826 VIA MAR ROSSO
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-2408
Mailing Address - Country:US
Mailing Address - Phone:561-229-9026
Mailing Address - Fax:
Practice Address - Street 1:3889 MILITARY TRL STE 102
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-2923
Practice Address - Country:US
Practice Address - Phone:561-485-1442
Practice Address - Fax:561-774-8574
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-06
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK37718208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice