Provider Demographics
NPI:1467496398
Name:MURILLO, JORGE (MD)
Entity Type:Individual
Prefix:
First Name:JORGE
Middle Name:
Last Name:MURILLO
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 1:8740 N KENDALL DR STE 208
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2221
Mailing Address - Country:US
Mailing Address - Phone:305-595-1594
Mailing Address - Fax:305-595-9708
Practice Address - Street 1:8740 N KENDALL DR STE 208
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2221
Practice Address - Country:US
Practice Address - Phone:305-595-1594
Practice Address - Fax:305-595-9708
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME78387207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL257869700Medicaid
FLK2459Medicare PIN
FLE3630UMedicare PIN
FL257869700Medicaid
FLE3630VMedicare PIN