Healthcare Provider Details

I. General information

NPI: 1134512064
Provider Name (Legal Business Name): ARSJ PEDIATRICS INFECTIOUS DISEASES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2015
Last Update Date: 03/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8940 N KENDALL DR SUITE 603E
MIAMI FL
33176-2148
US

IV. Provider business mailing address

8940 N KENDALL DR
MIAMI FL
33176-2148
US

V. Phone/Fax

Practice location:
  • Phone: 305-273-0026
  • Fax:
Mailing address:
  • Phone: 305-273-0026
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License Number
License Number StateFL

VIII. Authorized Official

Name: DR. ANTONIA R SAN JORGE
Title or Position: OWNER
Credential: MD
Phone: 305-273-0026