Requena Penenori, Jorge

Requena Penenori, Jorge is an individual health care provider with primary practice located at 1350 Hickory St Ste 101 , Melbourne FL 32901-3224. He recently has only one registered license in Allopathic & Osteopathic Physicians / Infectious Disease, which is considered as his primary health care specialty. Requena Penenori, Jorge can be contacted via phone (321) 361-5674.

Contact Information

Primary practice address
1350 Hickory St Ste 101 Melbourne FL 32901-3224
Phone: (321) 361-5674
Fax: (321) 676-6434
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Infectious Disease 207RI0200X ME138352 Florida

Profile Details

NPI number 1336534171
LBN Legal business name Requena Penenori, Jorge
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 30th, 2015
Last updated Sep 19th, 2023 - about last year

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 1336534171 NPPES
Florida Other N0906 HF MEDICARE
Florida MEDICAID 103078600 HF MEDICARE

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