Provider Demographics
NPI:1144291543
Name:JOSE ORCASITA-NG, LLC
Entity type:Organization
Organization Name:JOSE ORCASITA-NG, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:A
Authorized Official - Last Name:ORCASITA-NG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-362-9560
Mailing Address - Street 1:7000 W 12TH AVE
Mailing Address - Street 2:STE 21-22
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014-5154
Mailing Address - Country:US
Mailing Address - Phone:305-362-9560
Mailing Address - Fax:305-827-1581
Practice Address - Street 1:7000 W 12TH AVE
Practice Address - Street 2:STE 21-22
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-5154
Practice Address - Country:US
Practice Address - Phone:305-362-9560
Practice Address - Fax:305-827-1581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-01
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK0256Medicare ID - Type Unspecified