Provider Demographics
NPI:1639164056
Name:JORNALES, MARIA JANETA (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:JANETA
Last Name:JORNALES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:512B MCDOWELL AVE NE
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24016-1524
Mailing Address - Country:US
Mailing Address - Phone:540-362-9620
Mailing Address - Fax:540-362-9659
Practice Address - Street 1:512B MCDOWELL AVE NE
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016-1524
Practice Address - Country:US
Practice Address - Phone:540-362-9620
Practice Address - Fax:540-362-9659
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101058470207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine