# MR. ALFRED OTERO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1801011663
- **Gender:** Man
- **Credential:** PA-C, MPAS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | PA 0003636 | FL | Yes |

## Other

- **Enumeration date:** 04/16/2007
- **Last updated:** 06/12/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 291002100 | — | FL |