Healthcare Provider Details

I. General information

NPI: 1740153915
Provider Name (Legal Business Name): JORGE FELIX HURTADO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2025
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 S DIXIE HWY STE 4
LAKE WORTH FL
33460-4405
US

IV. Provider business mailing address

2618 FREEPORT RD
WEST PALM BEACH FL
33406-7709
US

V. Phone/Fax

Practice location:
  • Phone: 561-409-3418
  • Fax:
Mailing address:
  • Phone: 561-409-3418
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: