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1437158870

NPI Code Detail

MEDICARE: JORGE LUIS INFANTE M.D.

MEDICARE: JORGE LUIS INFANTE 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	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	27835	SC
2	207Q00000X	Family Medicine Physician	310829	LA
3	207P00000X	Emergency Medicine Physician	ME129975	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437158870
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORGE LUIS INFANTE M.D.

Provider Business Mailing Address
First Line	:	4504 MOORE ST
Second Line	:
City	:	NORTH MYRTLE BEACH
State	:	SC
Zip	:	29582-5220
Country	:	US
Telephone Number	:	843-663-1043
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 SINGLETON RIDGE RD
Second Line	:
City	:	CONWAY
State	:	SC
Zip	:	29526-9142
Country	:	US
Telephone Number	:	843-347-8015
Fax Number	:

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

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	01/02/2026

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Directions to “ JORGE LUIS INFANTE M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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