Provider Demographics
NPI:1033293873
Name:CASARIEGO, JORGE I (MD)
Entity Type:Individual
Prefix:DR
First Name:JORGE
Middle Name:I
Last Name:CASARIEGO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 560130
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33256-0130
Mailing Address - Country:US
Mailing Address - Phone:305-630-9244
Mailing Address - Fax:305-630-9223
Practice Address - Street 1:8600 SW 92ND ST
Practice Address - Street 2:SUITE 203
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-7397
Practice Address - Country:US
Practice Address - Phone:305-273-0027
Practice Address - Fax:305-595-8327
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00279192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD60082Medicare UPIN
FL92495Medicare ID - Type Unspecified