Basic Information
| Provider Information | |||||||||
| NPI: | 1104814581 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GARCIA-ARTEAGA | ||||||||
| FirstName: | JORGE | ||||||||
| MiddleName: | LUIS | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | P.A., BSN, RN. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20 SW 67TH AVE | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331442912 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7862713532 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8300 W FLAGLER ST | ||||||||
| Address2: | 210 | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331446000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055530270 | ||||||||
| FaxNumber: | 3055530670 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/11/2005 | ||||||||
| LastUpdateDate: | 07/07/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA9100726 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
ID Information
| ID | Type | State | Issuer | Description | PA9100726 | 01 | FL | PA STATE OF FL LICENSE | OTHER |