Provider Demographics
NPI:1316428113
Name:COBREIRO, JORGE A
Entity type:Individual
Prefix:
First Name:JORGE
Middle Name:A
Last Name:COBREIRO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8601 SW 94TH ST APT 121W
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-7364
Mailing Address - Country:US
Mailing Address - Phone:786-491-6582
Mailing Address - Fax:
Practice Address - Street 1:8601 SW 94TH ST APT 121W
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-7364
Practice Address - Country:US
Practice Address - Phone:786-491-6582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-28
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL8512661237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist