Provider Demographics
NPI:1497005482
Name:GINZO, JORGE GUSTAVO (RRT)
Entity Type:Individual
Prefix:MR
First Name:JORGE
Middle Name:GUSTAVO
Last Name:GINZO
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17350 NW 67TH AVE
Mailing Address - Street 2:APT 404
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-4257
Mailing Address - Country:US
Mailing Address - Phone:305-335-1352
Mailing Address - Fax:
Practice Address - Street 1:17350 NW 67TH AVE
Practice Address - Street 2:APT 404
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-4257
Practice Address - Country:US
Practice Address - Phone:305-335-1352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-17
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT 12019227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered