Provider Demographics
NPI:1023091089
Name:PELAEZ, JORGE M (MD)
Entity type:Individual
Prefix:DR
First Name:JORGE
Middle Name:M
Last Name:PELAEZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8333 N DAVIS HWY
Mailing Address - Street 2:MEDICAL CENTER CLINIC NEUROLOGY
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514
Mailing Address - Country:US
Mailing Address - Phone:850-474-8100
Mailing Address - Fax:850-474-8083
Practice Address - Street 1:8333 N DAVIS HWY
Practice Address - Street 2:WEST FLORIDA MEDICAL CENTER CLINIC PA
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514
Practice Address - Country:US
Practice Address - Phone:850-474-8353
Practice Address - Fax:850-474-8504
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2012-03-15
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Provider Licenses
StateLicense IDTaxonomies
FLME00758832084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G76237Medicare UPIN