Provider Demographics
NPI:1104814581
Name:GARCIA-ARTEAGA, JORGE LUIS (PA, BSN, RN)
Entity type:Individual
Prefix:DR
First Name:JORGE
Middle Name:LUIS
Last Name:GARCIA-ARTEAGA
Suffix:
Gender:M
Credentials:PA, BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 SW 67TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2912
Mailing Address - Country:US
Mailing Address - Phone:786-271-3532
Mailing Address - Fax:
Practice Address - Street 1:8300 W FLAGLER ST
Practice Address - Street 2:210
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-6000
Practice Address - Country:US
Practice Address - Phone:305-553-0270
Practice Address - Fax:305-553-0670
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9100726363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPA9100726OtherPA STATE OF FL LICENSE