MEDICARE: JORGE MUJICA MD

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	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	39186	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376618926
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORGE MUJICA MD

Provider Business Mailing Address
First Line	:	14571 KELSON CIR
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34114-8995
Country	:	US
Telephone Number	:	770-598-1825
Fax Number	:

Provider Business Practice Location Address
First Line	:	8300 COLLIER BLVD
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34114-3549
Country	:	US
Telephone Number	:	239-354-6190
Fax Number	:

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

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	08/21/2021

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