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General NPI Number Information
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NPI Number | 1659585552
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Entity Type | Individual
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Provider Name | JORGE MIGUEL KOURIE M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 2501 N ORANGE AVE SUITE 537N
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City | ORLANDO
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State | FL
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Zip | 32804-4603
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Country | US
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Telephone | 407-894-4693
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Fax | 407-896-0569
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Provider Business Mailing Address
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Address Line | 2180 W SR 434 STE 1164
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City | LONGWOOD
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State | FL
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Zip | 32779-5008
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Country | US
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Telephone | 407-894-4693
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Fax | 407-261-3869
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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 | ME104748
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License Number State | FL
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