Provider Demographics
NPI:1861495350
Name:ROSARIO-MULINELLI, JORGE A (MD)
Entity Type:Individual
Prefix:
First Name:JORGE
Middle Name:A
Last Name:ROSARIO-MULINELLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9500 S DADELAND BLVD
Mailing Address - Street 2:STE 802
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-2824
Mailing Address - Country:US
Mailing Address - Phone:305-468-4185
Mailing Address - Fax:305-675-3378
Practice Address - Street 1:9980 CENTRAL PARK BLVD N
Practice Address - Street 2:STE 316
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-1762
Practice Address - Country:US
Practice Address - Phone:561-206-6064
Practice Address - Fax:561-206-6068
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME1262712080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME126271OtherMEDICAL LICENSE
PRG40968Medicare UPIN