Healthcare Provider Details

I. General information

NPI: 1508403676
Provider Name (Legal Business Name): JORGE DUENAS GIURIA APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JORGE DUENAS GIURIA

II. Dates (important events)

Enumeration Date: 12/07/2019
Last Update Date: 09/29/2021
Certification Date: 09/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 SE 16TH AVE STE 303
OCALA FL
34471-4620
US

IV. Provider business mailing address

1720 SE 16TH AVE STE 303
OCALA FL
34471-4620
US

V. Phone/Fax

Practice location:
  • Phone: 352-369-0288
  • Fax: 352-867-1053
Mailing address:
  • Phone: 352-369-0288
  • Fax: 352-867-1053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11004939
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: