=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508837964
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOSE A ORCASITA-NG M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/01/2006
-----------------------------------------------------
Last Update Date | 05/10/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7000 W 12TH AVE STE 21-22
-----------------------------------------------------
City | HIALEAH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33014-5154
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-362-9560
-----------------------------------------------------
Fax | 305-827-1581
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7000 W 12TH AVE STE 21-22
-----------------------------------------------------
City | HIALEAH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33014-5154
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-362-9560
-----------------------------------------------------
Fax | 305-827-1581
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | ME0049312
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------