Healthcare Provider Details

I. General information

NPI: 1992771125
Provider Name (Legal Business Name): JORGE F FERIA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WILMA VAZQUEZ HOSPITAL SUITE 102, CALL BOX 7001
VEGA BAJA PR
00693
US

IV. Provider business mailing address

PO BOX 9078
BAYAMON PR
00960-8039
US

V. Phone/Fax

Practice location:
  • Phone: 787-858-1717
  • Fax: 787-858-2385
Mailing address:
  • Phone: 787-855-6241
  • Fax: 787-858-2385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number8650
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: