Doctor Name: | MS. FLORDELIZ ORTICIO JORGE |
NPI Number: | 1023104684 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | F304040 |
Business Practice Address: | 80th St & 41st Ave Elmhurst, NY - 113731329 |
Business Phone Number: | 7183345970 |
Business Fax Number: | 7183345958 |
Mailing Address: | 79-01 Broadway, D1-01 ELMHURST |
State: | NY |
Postal Code: | 113731329 |
Phone Number: | 7183341920 |
Fax Number: | 7183345958 |
NPI Enumeration Date: | 10/04/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | F304040 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |