Healthcare Provider Details

I. General information

NPI: 1124612114
Provider Name (Legal Business Name): JOSE BORGES APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2021
Last Update Date: 05/09/2026
Certification Date: 05/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1251 NW 36TH ST
MIAMI FL
33142-5532
US

IV. Provider business mailing address

8400 NW 33RD ST STE 201
DORAL FL
33122-1937
US

V. Phone/Fax

Practice location:
  • Phone: 786-814-4790
  • Fax:
Mailing address:
  • Phone: 844-665-4827
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11047375
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN9301627
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: