Provider Demographics
NPI:1811204746
Name:CONDE ORTIZ, CLAUDIA (MD)
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:
Last Name:CONDE ORTIZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2147
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-343-9888
Mailing Address - Fax:239-343-4262
Practice Address - Street 1:260 BETH STACEY BLVD UNIT 110
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33936-6074
Practice Address - Country:US
Practice Address - Phone:239-343-9888
Practice Address - Fax:239-343-4262
Is Sole Proprietor?:No
Enumeration Date:2010-09-14
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME167458208000000X
GA70069208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL127378100Medicaid