Provider Demographics
NPI:1689188179
Name:ARIAS, JORGE FERNANDO
Entity Type:Individual
Prefix:
First Name:JORGE
Middle Name:FERNANDO
Last Name:ARIAS
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 1:400 ARTHUR GODFREY RD STE 305
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33140-3523
Mailing Address - Country:US
Mailing Address - Phone:305-674-8586
Mailing Address - Fax:305-674-6686
Practice Address - Street 1:400 ARTHUR GODFREY RD STE 305
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33140-3523
Practice Address - Country:US
Practice Address - Phone:305-674-8586
Practice Address - Fax:305-674-6686
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-21
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant