Provider Demographics
NPI:1689854630
Name:JORGE F NETTO MD PA
Entity Type:Organization
Organization Name:JORGE F NETTO MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MEDICAL PRACTICE
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:F
Authorized Official - Last Name:NETTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-267-8805
Mailing Address - Street 1:5441 SW 144TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-5721
Mailing Address - Country:US
Mailing Address - Phone:305-267-8805
Mailing Address - Fax:305-267-8806
Practice Address - Street 1:5799 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:WEST MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-5033
Practice Address - Country:US
Practice Address - Phone:305-267-8805
Practice Address - Fax:305-267-8806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-07
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL26194OtherMEDICARE ID
FLF95237Medicare UPIN