MEDICARE: JORGE VERDECIA

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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1285169896
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORGE VERDECIA

Provider Business Mailing Address
First Line	:	6537 W FLAGLER ST APT 32
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-2952
Country	:	US
Telephone Number	:	786-316-6152
Fax Number	:

Provider Business Practice Location Address
First Line	:	6537 W FLAGLER ST APT 32
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-2952
Country	:	US
Telephone Number	:	786-316-6152
Fax Number	:

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

Provider Enumeration Date	:	04/21/2017
Last Update Date	:	04/21/2017

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Directions to “ JORGE VERDECIA ” Practice Location

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