Individual
OTTO OSTOLAZA-GARCIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4710 N HABANA AVE, SUITE 300, TAMPA, FL 33614-7151
(813) 873-1016
(813) 874-2813
Mailing address
4710 N HABANA AVE, SUITE 300, TAMPA, FL 33614-7151
(813) 873-1016
(813) 874-2813
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
17275
PR
207R00000X
Internal Medicine Physician
ME117767
FL
207RN0300X
Nephrology Physician
Primary
ME117767
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010280100
—
FL
01
—
ME117767
LICENSE NO
FL
01
—
P01402860
RR MEDICARE
FL
Enumeration date
03/15/2008
Last updated
03/15/2024
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