=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831584721
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JORGE L. BARBEITO M.D. P.A.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/30/2015
-----------------------------------------------------
Last Update Date | 03/30/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 259 E 49TH ST
-----------------------------------------------------
City | HIALEAH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33013-1854
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-826-1133
-----------------------------------------------------
Fax | 305-557-7459
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 259 E 49TH ST
-----------------------------------------------------
City | HIALEAH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33013-1854
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-826-1133
-----------------------------------------------------
Fax | 305-557-7459
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | M.D./OWNER
-----------------------------------------------------
Name | JORGE L BARBEITO
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 305-826-1133
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | ME44619
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------