Provider Demographics
NPI:1689186819
Name:MOREJON, JORGE ANTONIO (ARNP)
Entity Type:Individual
Prefix:MR
First Name:JORGE
Middle Name:ANTONIO
Last Name:MOREJON
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25312 SW 127TH PL
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-5716
Mailing Address - Country:US
Mailing Address - Phone:786-553-7979
Mailing Address - Fax:
Practice Address - Street 1:8200 SW 117TH AVE STE 416
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-4828
Practice Address - Country:US
Practice Address - Phone:786-409-7662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-27
Last Update Date:2017-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9249593363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily