MEDICARE: JORGE J DORTA-DUQUE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	ME56882	FL
2	2084P0804X	Child & Adolescent Psychiatry Physician	ME56882	FL

General Provider Information

NPI Number	:	1124053699
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORGE J DORTA-DUQUE M.D.

Provider Business Mailing Address
First Line	:	5151 ADANSON ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-1317
Country	:	US
Telephone Number	:	407-875-3700
Fax Number	:

Provider Business Practice Location Address
First Line	:	1800 MERCY DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32808-5646
Country	:	US
Telephone Number	:	407-875-3700
Fax Number	:	407-822-5024

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	12/10/2025

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