MEDICARE: JORGE AMAYA 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	207R00000X	Internal Medicine Physician	ME 47888	FL
2	208D00000X	General Practice Physician	ME 47888	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	:	1811093735
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORGE AMAYA M.D.

Provider Business Mailing Address
First Line	:	11501 SW 40TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-3313
Country	:	US
Telephone Number	:	305-642-5366
Fax Number	:	305-631-3828

Provider Business Practice Location Address
First Line	:	6825 SW 59TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33143-1907
Country	:	US
Telephone Number	:	786-493-9557
Fax Number	:	305-821-3666

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

Provider Enumeration Date	:	09/16/2006
Last Update Date	:	10/06/2016

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