Individual
JESSICA ANN ORTEGA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
1515 DR MARTIN LUTHER KING JR BLVD, MELBOURNE, FL 32901-2946
(321) 723-3500
(321) 723-1945
Mailing address
1515 DR MARTIN LUTHER KING JR BLVD, MELBOURNE, FL 32901-2946
(321) 723-3500
(321) 723-1945
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO3766
FL
213ES0103X
Foot & Ankle Surgery Podiatrist
PO3766
FL
213ES0103X
Foot & Ankle Surgery Podiatrist
SC006487
PA
Other
Enumeration date
06/27/2013
Last updated
05/12/2023
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