Provider Demographics
NPI:1780659987
Name:FLORIN, JORGE LUIS (MD)
Entity Type:Individual
Prefix:
First Name:JORGE
Middle Name:LUIS
Last Name:FLORIN
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 1:1804 OAKLEY SEAVER DR STE A
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-1925
Mailing Address - Country:US
Mailing Address - Phone:407-521-3600
Mailing Address - Fax:407-521-3603
Practice Address - Street 1:2000 FOWLER GROVE BLVD FL 3
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-5050
Practice Address - Country:US
Practice Address - Phone:407-521-3600
Practice Address - Fax:407-521-3603
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME55271208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1780659987OtherNPI
FL12120OtherBCBS PROVIDER NUMBER
FL055141400Medicaid
FLE82562Medicare UPIN