Provider Demographics
NPI:1427017797
Name:BEATO, JORGE R (MD)
Entity Type:Individual
Prefix:
First Name:JORGE
Middle Name:R
Last Name:BEATO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JORGE
Other - Middle Name:R
Other - Last Name:BEATO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:330 SW 27TH AVE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-2961
Mailing Address - Country:US
Mailing Address - Phone:305-858-3226
Mailing Address - Fax:305-859-8330
Practice Address - Street 1:330 SW 27TH AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-2961
Practice Address - Country:US
Practice Address - Phone:305-858-3226
Practice Address - Fax:305-859-8330
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0036025207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL040519100Medicaid
FL040519100Medicaid
D78995Medicare UPIN