Provider Demographics
NPI:1477672178
Name:GIL - SABINA, JORGE J (MD)
Entity Type:Individual
Prefix:
First Name:JORGE
Middle Name:J
Last Name:GIL - SABINA
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 1:14221 SW 120TH ST
Mailing Address - Street 2:SUITE 129
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-7236
Mailing Address - Country:US
Mailing Address - Phone:305-279-1515
Mailing Address - Fax:305-279-1219
Practice Address - Street 1:14221 SW 120TH ST
Practice Address - Street 2:SUITE 129
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-7236
Practice Address - Country:US
Practice Address - Phone:305-279-1515
Practice Address - Fax:305-279-1219
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2012-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 84841208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL264618800Medicaid
FLK6457Medicare ID - Type Unspecified
FLH66799Medicare UPIN