Individual
YANCARLOS ORTEGA GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6914 W 24TH LN, HIALEAH, FL 33016-5471
(786) 351-0408
Mailing address
6914 W 24TH LN, HIALEAH, FL 33016-5471
(786) 351-0408
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
O632960870580
DRIVER LICENCE
FL
Enumeration date
04/05/2018
Last updated
04/05/2018
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