Individual
JORGE LUIS OPORTA TELLEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SA-C
Contact information
Practice address
5990 TERRACE PARK DR N UNIT 209, ST PETERSBURG, FL 33709-1153
(727) 598-3703
Mailing address
5990 TERRACE PARK DR N UNIT 209, ST PETERSBURG, FL 33709-1153
(727) 598-3703
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
24-336
FL
Other
Enumeration date
06/26/2024
Last updated
06/26/2024
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