Provider Demographics
NPI:1508837964
Name:ORCASITA-NG, JOSE A (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:A
Last Name:ORCASITA-NG
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 1:7000 W 12TH AVE
Mailing Address - Street 2:STE 21-22
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014-5154
Mailing Address - Country:US
Mailing Address - Phone:305-362-9560
Mailing Address - Fax:305-827-1581
Practice Address - Street 1:7000 W 12TH AVE
Practice Address - Street 2:STE 21-22
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-5154
Practice Address - Country:US
Practice Address - Phone:305-362-9560
Practice Address - Fax:305-827-1581
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-01
Last Update Date:2010-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0049312207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD20947Medicare UPIN
FL04599Medicare ID - Type Unspecified