Provider Demographics
NPI:1144361916
Name:BORGES, JORGE F (DMD)
Entity type:Individual
Prefix:
First Name:JORGE
Middle Name:F
Last Name:BORGES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 SW 135TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3210
Mailing Address - Country:US
Mailing Address - Phone:305-220-5784
Mailing Address - Fax:
Practice Address - Street 1:8000 W FLAGLER ST STE 204
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2153
Practice Address - Country:US
Practice Address - Phone:305-266-5222
Practice Address - Fax:305-262-3289
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN15375122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist