Basic Information
Provider Information
NPI: 1881957256
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ORTEGA FERNANDEZ
FirstName: BEATRIZ
MiddleName: E.
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5955 PONCE DE LEON BLVD
Address2:  
City: CORAL GABLES
State: FL
PostalCode: 331462423
CountryCode: US
TelephoneNumber: 3056611515
FaxNumber: 3056623723
Practice Location
Address1: 501 6TH AVE S
Address2:  
City: ST PETERSBURG
State: FL
PostalCode: 337014634
CountryCode: US
TelephoneNumber: 7277674243
FaxNumber: 7277678612
Other Information
ProviderEnumerationDate: 06/20/2012
LastUpdateDate: 03/09/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/09/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000XME119630FLN Allopathic & Osteopathic PhysiciansPediatrics 
208M00000XME119630FLY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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