MEDICARE: DR. JORGE MINERA 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	207Q00000X	Family Medicine Physician	0101243523	VA

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	:	1750389987
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JORGE MINERA M.D.

Provider Business Mailing Address
First Line	:	493 BLACKWELL RD STE 202
Second Line	:
City	:	WARRENTON
State	:	VA
Zip	:	20186-2689
Country	:	US
Telephone Number	:	540-347-4400
Fax Number	:

Provider Business Practice Location Address
First Line	:	493 BLACKWELL RD
Second Line	:	SUITE 202
City	:	WARRENTON
State	:	VA
Zip	:	20186-2639
Country	:	US
Telephone Number	:	540-347-4400
Fax Number	:

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

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	10/21/2025

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