Jorge Luis Carrillo Moya, HSE

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

HSE36492 Issued in FL

Practice address

1321 NW 14TH St BLDG Suite505
Miami, FL 33125-1673

Phone

(305) 243-6704

Fax

(305) 243-6191

NPI assigned

Jun 12, 2023

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1686528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1114601192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 NW 14TH ST BLDG SUITE505",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331251673",
            "telephone_number": "305-243-6704",
            "fax_number": "305-243-6191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 NW 14TH ST BLDG SUITE505",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331251673",
            "telephone_number": "305-243-6704",
            "fax_number": "305-243-6191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRILLO MOYA",
        "first_name": "JORGE",
        "middle_name": "LUIS",
        "credential": "HSE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-12",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "HSE36492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karla Carrillo Garteiz, BCBA
• Valentina Del Valle Carrillo Gracia, DDS
• Laimi Carrillo Hernandez
• Adriana A Carrillo Iregui, MD
• Carrillo Medical Services Inc
• Miladys Carrillo Paulke
• Yasmary Carrillo Ravelo, RBT
• Alexander Carrillo, DPT
• Barbara Carrillo, LCSW
• Blake Ernesto Carrillo, PA-C

• Dermatology Physician in Miami, FL
• Providers in Miami, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.