Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 170100000X | Medical Geneticist | ME 90543 | FL |
Y | 207R00000X | Internist | ME90543 | FL |
Y | 111NI0900X | Internist | ME90543 | FL |
NPI | 1437135894 |
---|---|
Provider Name | Dr. Vanessa Jorge |
First Address | Winter Springs, FL 32708-6622 |
Second Address | Winter Springs, FL 32708-6622 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2005 |
Last Update Date | 19/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001751500 | (05) | FL |
I25893 | (02) | FL |