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General NPI Number Information
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NPI Number | 1194820944
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Entity Type | Individual
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Provider Name | JORGE LUIS AJURIA M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 4800 NE 20TH TER STE 211
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-4510
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Country | US
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Telephone | 954-932-4221
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Fax | 754-200-0878
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Provider Business Mailing Address
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Address Line | 4800 NE 20TH TER STE 211
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-4510
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Country | US
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Telephone | 954-932-4221
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Fax | 754-200-0878
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | ME87901
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License Number State | FL
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