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Organization
ORTAVERA CORPORATION
Active
Organization
ORTAVERA CORPORATION
Active
Other names
MOL Medical
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALBERTO ORTA IGLESIAS MD (PRESIDENT)
(786) 718-5454
Entity
Organization
Contact information
Practice address
13500 SW 88TH ST STE 211, MIAMI, FL 33186-1528
(786) 873-7807
(786) 502-3985
Mailing address
14996 SW 108TH TER, MIAMI, FL 33196-2507
(786) 718-5454
(786) 502-3985
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208600000X
Surgery Physician
—
—
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
05/21/2020
Last updated
12/05/2023
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