Bacallao, Jorge Juan

Bacallao, Jorge Juan is an sole proprietor health care provider with primary practice located at 5858 Sw 68Th St , South Miami FL 33143-3693. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Bacallao, Jorge Juan can be contacted via phone (305) 661-8588.

Contact Information

Primary practice address
5858 Sw 68Th St South Miami FL 33143-3693
Phone: (305) 661-8588
Fax: (305) 661-4906
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X ME 92076 Florida

Profile Details

NPI number 1275549511
LBN Legal business name Bacallao, Jorge Juan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 31st, 2006
Last updated Feb 15th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275549511 NPPES
Florida MEDICAID 268789500

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