Provider Demographics
NPI:1518732163
Name:ORTIZ COLON, ESTRELLA CELESTE
Entity Type:Individual
Prefix:MRS
First Name:ESTRELLA
Middle Name:CELESTE
Last Name:ORTIZ COLON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5003 QUERCUS LOOP
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33880-8809
Mailing Address - Country:US
Mailing Address - Phone:787-204-2351
Mailing Address - Fax:
Practice Address - Street 1:5003 QUERCUS LOOP
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-8809
Practice Address - Country:US
Practice Address - Phone:787-204-2351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-22
Last Update Date:2024-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101YA0400X, 101YP1600X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral