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General NPI Number Information
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NPI Number | 1124053699
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Entity Type | Individual
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Provider Name | JORGE J DORTA-DUQUE M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 1800 MERCY DR
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City | ORLANDO
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State | FL
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Zip | 32808-5646
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Country | US
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Telephone | 407-875-3700
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Fax | 407-822-5024
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Provider Business Mailing Address
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Address Line | 5151 ADANSON ST
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City | ORLANDO
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State | FL
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Zip | 32804-1317
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Country | US
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Telephone | 407-875-3700
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME56882
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | ME56882
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License Number State | FL
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