MEDICARE: DR. JULIO GORGA SR. M.D.

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	208D00000X	General Practice Physician	ME165247	FL

General Provider Information

NPI Number	:	1265551444
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JULIO GORGA SR. M.D.

Provider Business Mailing Address
First Line	:	5887 LAKE WORTH RD
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33463-3209
Country	:	US
Telephone Number	:	561-469-6502
Fax Number	:	561-612-7007

Provider Business Practice Location Address
First Line	:	5887 LAKE WORTH RD
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33463-3209
Country	:	US
Telephone Number	:	561-469-6502
Fax Number	:	561-612-7007

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

Provider Enumeration Date	:	03/28/2007
Last Update Date	:	09/10/2025

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