Individual
JORGE ENRIQUE PERDOMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(786) 556-7128
Mailing address
15902 SW 64TH TER, MIAMI, FL 33193-3649
(786) 556-7128
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/27/2023
Last updated
05/21/2023
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