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General NPI Number Information
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NPI Number | 1083068894
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Entity Type | Individual
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Provider Name | ERIC AUSTIN JORGE MD
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Gender | Male
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Dates
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Enumeration Date | 04/18/2016
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Last Update Date | 12/20/2023
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Provider Practice Location Address
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Address Line | 13001 SOUTHERN BLVD
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City | LOXAHATCHEE
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State | FL
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Zip | 33470-9203
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Country | US
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Telephone | 561-345-7009
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Fax |
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Provider Business Mailing Address
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Address Line | 1084 EGRET CIR N
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City | JUPITER
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State | FL
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Zip | 33458-8313
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Country | US
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Telephone | 561-676-1332
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD.35659
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 2080P0204X
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Taxonomy Name | Pediatric Emergency Medicine (Pediatrics) Physician
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License Number | 154838
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License Number State | FL
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