Provider Demographics
NPI:1417963802
Name:GARCIA-JORGE, ASHLEY JESUS (MD)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:JESUS
Last Name:GARCIA-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 1:1575 AVE MUNOZ RIVERA
Mailing Address - Street 2:PMB 316
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717-0211
Mailing Address - Country:US
Mailing Address - Phone:787-844-2030
Mailing Address - Fax:787-844-2030
Practice Address - Street 1:1575 AVE MUNOZ RIVERA
Practice Address - Street 2:PMB 316
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-0211
Practice Address - Country:US
Practice Address - Phone:787-844-2030
Practice Address - Fax:787-844-2030
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14355208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
I50345Medicare UPIN
0021223Medicare ID - Type Unspecified