Provider Demographics
NPI:1154323871
Name:ORDONEZ, JOSE RENE (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:RENE
Last Name:ORDONEZ
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 1:801 MEADOWS RD
Mailing Address - Street 2:STE 105
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-2346
Mailing Address - Country:US
Mailing Address - Phone:561-392-2021
Mailing Address - Fax:561-394-4175
Practice Address - Street 1:801 MEADOWS RD
Practice Address - Street 2:STE 105
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-2346
Practice Address - Country:US
Practice Address - Phone:561-392-2021
Practice Address - Fax:561-394-4175
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0059688207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL370671100Medicaid
060025663OtherRAILROAD MEDICARE
F31725Medicare UPIN
FL370671100Medicaid