Provider Demographics
NPI:1417003575
Name:JORGE, WILLIAM ALFREDO (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:ALFREDO
Last Name:JORGE
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 1:343 CAMINO DE LOS LIRIOS
Mailing Address - Street 2:SABANERA DEL RIO
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-5249
Mailing Address - Country:US
Mailing Address - Phone:787-743-1130
Mailing Address - Fax:787-286-0536
Practice Address - Street 1:CALLE 27 AA1 #4 AVE. BAIROA
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-744-1577
Practice Address - Fax:787-286-0536
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11848207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology