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Individual
MIGUEL A DE LA RUA JORGE
Active
Individual
MIGUEL A DE LA RUA JORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
GERONTOLOGY APRN
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
APRN11004260
FL
363LG0600X
Gerontology Nurse Practitioner
RN9483054
FL
Other
Enumeration date
09/25/2019
Last updated
06/16/2026
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