Provider Demographics
NPI:1285925099
Name:JORGE L. SOSA, M.D., P.A.
Entity type:Organization
Organization Name:JORGE L. SOSA, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:L
Authorized Official - Last Name:SOSA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-558-0411
Mailing Address - Street 1:3499 W 4TH AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-4333
Mailing Address - Country:US
Mailing Address - Phone:305-558-0411
Mailing Address - Fax:305-863-3802
Practice Address - Street 1:3499 W 4TH AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-4333
Practice Address - Country:US
Practice Address - Phone:305-558-0411
Practice Address - Fax:305-863-3802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-27
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME55406174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty