Individual
DR. JACKELINE T GOMEZ-JORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
401 MIRACLE MILE, SUITE 103, CORAL GABLES, FL 33134
(888) 211-9355
Mailing address
401 MIRACLE MILE, SUITE 103, CORAL GABLES, FL 33134
(888) 211-9355
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
ME-66752
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
179079
JACKSON MEMORIAL
FL
05
—
2594153-00
—
FL
01
—
272922
AVMED
FL
01
—
35884
BLUE SHIELD
FL
01
—
48767
NEIGHBORHOOD HEALTH PLAN
FL
01
—
5020703
AETNA
FL
01
—
6643476
CIGNA
FL
Enumeration date
05/31/2005
Last updated
01/17/2017
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