Provider Demographics
NPI:1700588449
Name:GARCIA BLAYA, JORGE KARELL (MD)
Entity Type:Individual
Prefix:DR
First Name:JORGE
Middle Name:KARELL
Last Name:GARCIA BLAYA
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 1:11385 SW DISCOVERY WAY APT 208
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34987-2570
Mailing Address - Country:US
Mailing Address - Phone:786-712-0842
Mailing Address - Fax:
Practice Address - Street 1:11880 BIRD RD STE 101
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3573
Practice Address - Country:US
Practice Address - Phone:305-485-4677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program