Doctor Name: | DR. ZUMILVETTE ORTIZ DETRES |
NPI Number: | 1861632200 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 17492 |
Business Practice Address: | 7901 Kingspointe Pkwy Ste1 Orlando, FL - 328196520 |
Business Phone Number: | 4072402361 |
Business Fax Number: | 4073458895 |
Mailing Address: | 7901 Kingspointe Pkwy, Ste1 ORLANDO |
State: | FL |
Postal Code: | 328196520 |
Phone Number: | 4072402361 |
Fax Number: | 4073458895 |
NPI Enumeration Date: | 02/25/2009 |
NPI Last Update Date: | 10/29/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 17492 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |