Provider Demographics
NPI:1619958824
Name:PASTORIZA, JORGE (MD)
Entity Type:Individual
Prefix:MR
First Name:JORGE
Middle Name:
Last Name:PASTORIZA
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 1:9193 SUNSET DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3487
Mailing Address - Country:US
Mailing Address - Phone:305-595-5558
Mailing Address - Fax:305-595-4121
Practice Address - Street 1:9193 SUNSET DR
Practice Address - Street 2:SUITE 210
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3487
Practice Address - Country:US
Practice Address - Phone:305-595-5558
Practice Address - Fax:305-595-4121
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME30787207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001263OtherNHP
FL95240OtherBCBS
FL95240OtherBCBS
D27852Medicare UPIN