Provider Demographics
NPI:1225100803
Name:FIGUEROA, JORGE ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:JORGE
Middle Name:ANTHONY
Last Name:FIGUEROA
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 1:7600 BRYAN DAIRY RD STE D
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33777-1433
Mailing Address - Country:US
Mailing Address - Phone:727-351-0099
Mailing Address - Fax:844-388-6186
Practice Address - Street 1:7600 BRYAN DAIRY RD STE D
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33777-1433
Practice Address - Country:US
Practice Address - Phone:727-351-0099
Practice Address - Fax:844-388-6186
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2019-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0060819207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F18645Medicare UPIN
14604AMedicare PIN