De La Rua Jorge, Miguel A

De La Rua Jorge, Miguel A is an individual health care provider with primary practice located at 6565 Taft St Ste 100 , Hollywood FL 33024-4000. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as his primary health care specialty. De La Rua Jorge, Miguel A can be contacted via phone (954) 331-4966.

Contact Information

Primary practice address
6565 Taft St Ste 100 Hollywood FL 33024-4000
Phone: (954) 331-4966
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X APRN11004260 Florida
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X RN9483054 Florida

Profile Details

NPI number 1437700093
LBN Legal business name De La Rua Jorge, Miguel A
Credentials GERONTOLOGY APRN
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 25th, 2019
Last updated Jun 16th, 2026 - about 4 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437700093 NPPES
Florida Other AG09190084 AANPCB CERTIFICATION NUMBER FLORIDA BOARD OF NURSING
Florida Other L0456 AANPCB CERTIFICATION NUMBER FLORIDA BOARD OF NURSING

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