Provider Demographics
NPI:1265405625
Name:JOVANE, JORGE R (MD)
Entity type:Individual
Prefix:DR
First Name:JORGE
Middle Name:R
Last Name:JOVANE
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:PO BOX 10632
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00732-1632
Mailing Address - Country:US
Mailing Address - Phone:787-843-7140
Mailing Address - Fax:787-841-7090
Practice Address - Street 1:EDIFICIO PORRATA PLA
Practice Address - Street 2:2131 BULEVAR LUIS A FERRE SUITE 100
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-0643
Practice Address - Country:US
Practice Address - Phone:787-840-2277
Practice Address - Fax:787-841-7090
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7317207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
29699Medicare ID - Type Unspecified
C82317Medicare UPIN