Individual
MARY OTTINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2 TAMPA GENERAL CIR, TAMPA, FL 33606-3603
(813) 259-0929
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME124593
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021416600
—
FL
01
—
IPMGZ
BLUE CROSS BLUE SHIELD
FL
Enumeration date
05/11/2010
Last updated
03/17/2018
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