MEDICARE: DR. CARLOS B JORGE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	200201267	NC

General Provider Information

NPI Number	:	1013925486
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARLOS B JORGE MD

Provider Business Mailing Address
First Line	:	3820 RANDOLPH HEIGHTS DR STE 150
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28205-7566
Country	:	US
Telephone Number	:	704-360-5018
Fax Number	:	980-273-1102

Provider Business Practice Location Address
First Line	:	3820 RANDOLPH HEIGHTS DR STE 150
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28205-7566
Country	:	US
Telephone Number	:	704-360-5018
Fax Number	:	980-273-1102

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	05/28/2025

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