Healthcare Provider Details

I. General information

NPI: 1851473078
Provider Name (Legal Business Name): JORGE L. ARZOLA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

F1 CALLE BEACON CAMBRIDGE PARK
SAN JUAN PR
00926-1445
US

IV. Provider business mailing address

F1 CALLE BEACON CAMBRIDGE PARK
SAN JUAN PR
00926-1445
US

V. Phone/Fax

Practice location:
  • Phone: 787-758-7150
  • Fax: 787-758-7150
Mailing address:
  • Phone: 787-758-7150
  • Fax: 787-758-7150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4917
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number4917
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: