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Individual

MR. JORGE LUIS ANIBAL MIRABELLI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
570 MEMORIAL CIR, SUITE 200, ORMOND BEACH, FL 32174-5002
(386) 451-2346
Mailing address
570 MEMORIAL CIR, SUITE 200, ORMOND BEACH, FL 32174-5002
(386) 944-9813
(386) 317-0664

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
ME101968
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0001216-00
FL
05
2504810
OH
05
670456672A
GA
01
P00174902
MCR RR
Enumeration date
07/09/2006
Last updated
01/31/2024
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