Provider Demographics
NPI:1619209541
Name:SOMOZA, JORGE (RRT)
Entity Type:Individual
Prefix:MR
First Name:JORGE
Middle Name:
Last Name:SOMOZA
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 1:8267 N ROCKY BROOK DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85743-1475
Mailing Address - Country:US
Mailing Address - Phone:520-743-0597
Mailing Address - Fax:
Practice Address - Street 1:8267 N ROCKY BROOK DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85743-1475
Practice Address - Country:US
Practice Address - Phone:520-743-0597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-03
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ001296227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered