Provider Demographics
NPI:1982873360
Name:ORTEGA-BERMUDEZ, ANGELA NICOLE (DO)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:NICOLE
Last Name:ORTEGA-BERMUDEZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:ORTEGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2847 SAINT ROSE PKWY STE 150
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4845
Mailing Address - Country:US
Mailing Address - Phone:702-213-4848
Mailing Address - Fax:702-213-5885
Practice Address - Street 1:2847 SAINT ROSE PKWY STE 150
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4845
Practice Address - Country:US
Practice Address - Phone:702-213-4848
Practice Address - Fax:702-213-5885
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-29
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1539207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV71392OtherMEDICARE