Provider Demographics
NPI:1740251891
Name:ORTEGA, PEDRO LUIS (MD)
Entity type:Individual
Prefix:DR
First Name:PEDRO
Middle Name:LUIS
Last Name:ORTEGA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3727 N GOLDENROD RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-8611
Mailing Address - Country:US
Mailing Address - Phone:407-478-0028
Mailing Address - Fax:407-476-0297
Practice Address - Street 1:3727 N GOLDENROD RD
Practice Address - Street 2:SUITE 106
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-8611
Practice Address - Country:US
Practice Address - Phone:407-478-0028
Practice Address - Fax:407-476-0297
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-27
Last Update Date:2023-03-14
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Provider Licenses
StateLicense IDTaxonomies
FLME75974207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009320800Medicaid
FL009320800Medicaid