Individual
JASON BORREGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11750 SW 40TH ST, MIAMI, FL 33175-3530
(305) 223-3000
Mailing address
4331 SW 12TH ST, MIAMI, FL 33134-2712
(305) 510-2509
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9389621
FL
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
APRN11001636
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN11001636
FL
367500000X
Certified Registered Nurse Anesthetist
D185180
IA
Other
Enumeration date
01/31/2019
Last updated
02/02/2026
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