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General NPI Number Information
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NPI Number | 1578582318
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Entity Type | Individual
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Provider Name | JORGE NAZARIO M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 12/13/2022
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Provider Practice Location Address
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Address Line | 5235 W COLONIAL DR
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City | ORLANDO
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State | FL
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Zip | 32808-7605
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Country | US
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Telephone | 689-698-1820
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Fax | 689-698-1822
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Provider Business Mailing Address
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Address Line | PO BOX 263
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City | NARANJITO
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State | PR
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Zip | 00719-0071
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Country | US
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Telephone | 787-869-4842
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Fax | 787-869-4842
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ACN1411
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License Number State | FL
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