Healthcare Provider Details

I. General information

NPI: 1063408029
Provider Name (Legal Business Name): JORGE L ALSINA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2005
Last Update Date: 02/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4999 W 8TH AVE SUITE 26
HIALEAH FL
33012-3409
US

IV. Provider business mailing address

4999 W 8TH AVE SUITE 26
HIALEAH FL
33012-3409
US

V. Phone/Fax

Practice location:
  • Phone: 305-556-4447
  • Fax: 305-556-6290
Mailing address:
  • Phone: 305-556-4447
  • Fax: 305-556-6290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME81871
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: