Healthcare Provider Details

I. General information

NPI: 1659763472
Provider Name (Legal Business Name): JORGE ANTONIO URGELL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JORGE ANTONIO URGELL NP-C

II. Dates (important events)

Enumeration Date: 03/03/2015
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

551 E 49TH ST
HIALEAH FL
33013-1904
US

IV. Provider business mailing address

6101 BLUE LAGOON DR STE 200
MIAMI FL
33126-3168
US

V. Phone/Fax

Practice location:
  • Phone: 305-819-7770
  • Fax: 844-697-3528
Mailing address:
  • Phone: 305-500-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberMU4371516
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: