Provider Demographics
NPI:1851657597
Name:PUENTE ESPEL, JORDI (MD)
Entity Type:Individual
Prefix:DR
First Name:JORDI
Middle Name:
Last Name:PUENTE ESPEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JORDI
Other - Middle Name:
Other - Last Name:PUENTE-ESPEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1040 S MURRAY HILL LN
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-2631
Mailing Address - Country:US
Mailing Address - Phone:346-717-7607
Mailing Address - Fax:
Practice Address - Street 1:1040 S MURRAY HILL LN
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-2631
Practice Address - Country:US
Practice Address - Phone:346-717-7607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-06
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS275502086S0122X, 2086S0122X
GA853892086S0122X
OH35.1370142086S0122X
TN594182086S0122X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program