Provider Demographics
NPI:1558857904
Name:SORIA MONCADA, JORGE MARKO (MD)
Entity Type:Individual
Prefix:DR
First Name:JORGE
Middle Name:MARKO
Last Name:SORIA MONCADA
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 1:1508 MARCATO LN NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87104
Mailing Address - Country:US
Mailing Address - Phone:773-697-1704
Mailing Address - Fax:
Practice Address - Street 1:5901 HARPER DR NE BLDG 1 OR ENTRANCE A
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-3714
Practice Address - Country:US
Practice Address - Phone:505-848-3730
Practice Address - Fax:505-848-3732
Is Sole Proprietor?:No
Enumeration Date:2018-07-09
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2023-0193174400000X, 207RI0200X
IL125071662207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No174400000XOther Service ProvidersSpecialist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine