Provider Demographics
NPI:1639279003
Name:ORTEGA, CHRISTIAN I (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:I
Last Name:ORTEGA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1266 W FLAGLER ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-2420
Mailing Address - Country:US
Mailing Address - Phone:305-388-6109
Mailing Address - Fax:305-631-9812
Practice Address - Street 1:1266 W FLAGLER ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-2420
Practice Address - Country:US
Practice Address - Phone:305-649-2222
Practice Address - Fax:305-631-9812
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS38256183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist