Provider Demographics
NPI:1699102392
Name:ORTEGA-NAVAS, DAVID (RN)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:ORTEGA-NAVAS
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17631 COBB AVE
Mailing Address - Street 2:
Mailing Address - City:POOLESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20837-9419
Mailing Address - Country:US
Mailing Address - Phone:240-477-3769
Mailing Address - Fax:
Practice Address - Street 1:200 GIRARD ST
Practice Address - Street 2:212A
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-3466
Practice Address - Country:US
Practice Address - Phone:301-216-0880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-26
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR201142163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse