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Jorge Manuel Gomez Vizcarra
General Practice Physician in North Miami, Florida
NPI 1366911471

Jorge Manuel Gomez Vizcarra is a General Practice Physician based in Spring Hill, FL. Jorge Manuel Gomez Vizcarra practices in North Miami, FL. The NPI Number for Jorge Manuel Gomez Vizcarra is 1366911471 and holds a License No. 21111 (Florida).

The current practice location address for Jorge Manuel Gomez Vizcarra is 14900 W Dixie Hwy, North Miami, FL and can be reached out via phone at 305-995-0539 and via fax at 305-995-0538.

Location: 14900 W Dixie Hwy, North Miami, FL, 34609-5657
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1366911471
Provider Name
Jorge Manuel Gomez Vizcarra
Credential
Provider Entity Type
Individual
Gender
Male
Address
14900 W Dixie Hwy, North Miami, FL, 34609-5657
Phone Number
305-995-0539
Fax Number
305-995-0538
Provider Enumeration Date
11/19/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
111375300 05 FL
institution
Provider Business Practice Location Address Details
Address
14900 W Dixie Hwy
City
North Miami
State
Florida
Zip
33181-1018
Phone Number
305-995-0539
Fax Number
305-995-0538
person
Provider Business Mailing Address Details
Address
14900 W Dixie Hwy
City
North Miami
State
Florida
Zip
33181-1018
Phone Number
305-995-0539
Fax Number
305-995-0538
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
21111 ()
Definition
Definition to come...
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