Individual
DR. EDNA MARIE ORTOLANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
15575 NW 12TH PL, PEMBROKE PINES, FL 33028-1617
(954) 447-9007
Mailing address
903 BELL SPRINGS RD, DRIPPING SPRINGS, TX 78620-2401
(954) 540-0572
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
9232T
TX
152W00000X
Optometrist
OPC 3259
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
620406601
—
FL
Enumeration date
02/10/2007
Last updated
10/23/2018
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