MEDICARE: JORGE L CARDENAS-ZITO MD PA

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	261QP2300X	Primary Care Clinic/Center	ME0059835	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225209612
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JORGE L CARDENAS-ZITO MD PA

Provider Business Mailing Address
First Line	:	4999 W 8TH AVE
Second Line	:	SUITE #22
City	:	HIALEAH
State	:	FL
Zip	:	33012-3409
Country	:	US
Telephone Number	:	305-821-2333
Fax Number	:	305-828-6984

Provider Business Practice Location Address
First Line	:	4999 W 8TH AVE
Second Line	:	SUITE # 22
City	:	HIALEAH
State	:	FL
Zip	:	33012-3409
Country	:	US
Telephone Number	:	305-821-2333
Fax Number	:	305-828-6984

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JORGE L CARDENAS
Credential	:	MD
Telephone Number	:	305-821-2333

Provider Enumeration Date	:	03/13/2008
Last Update Date	:	09/12/2008

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