Provider Demographics
NPI:1609330026
Name:FIGUEROA, JORGE
Entity Type:Individual
Prefix:
First Name:JORGE
Middle Name:
Last Name:FIGUEROA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:568 YORK AVE
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-3448
Mailing Address - Country:US
Mailing Address - Phone:540-327-0647
Mailing Address - Fax:540-369-6279
Practice Address - Street 1:568 YORK AVE
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-3448
Practice Address - Country:US
Practice Address - Phone:540-327-0647
Practice Address - Fax:540-369-6279
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-30
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAT63190009347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle