Gomez Vizcarra, Jorge Manuel

Gomez Vizcarra, Jorge Manuel is an sole proprietor health care provider with primary practice located at 14900 W Dixie Hwy , North Miami FL 33181-1018. He recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as his primary health care specialty. Gomez Vizcarra, Jorge Manuel can be contacted via phone (305) 995-0539.

Contact Information

Primary practice address
14900 W Dixie Hwy North Miami FL 33181-1018
Phone: (305) 995-0539
Fax: (305) 995-0538
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X 21111 Puerto Rico
Allopathic & Osteopathic Physicians / General Practice 208D00000X ACN1356 Florida

Profile Details

NPI number 1366911471
LBN Legal business name Gomez Vizcarra, Jorge Manuel
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 19th, 2018
Last updated Mar 24th, 2022 - about 2 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 1366911471 NPPES
Florida MEDICAID 111375300

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