MEDICARE: NUBIA ORJUELA

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	261QR0208X	Mobile Radiology Clinic/Center
2	246XS1301X	Sonography Specialist/Technologist Cardiovascular	ME 66670	FL

General Provider Information

NPI Number	:	1972537587
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NUBIA ORJUELA

Provider Business Mailing Address
First Line	:	10739 TAVISTOCK DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33626-1718
Country	:	US
Telephone Number	:	813-417-5888
Fax Number	:

Provider Business Practice Location Address
First Line	:	13904 GLOVER PL
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33613-3126
Country	:	US
Telephone Number	:	813-417-5888
Fax Number	:	813-962-8350

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

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	04/15/2024

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Directions to “ NUBIA ORJUELA ” Practice Location

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