Individual provider Active NPI

Jorge Jarquin, CSA

  • Surgical Assistant
  • Fort Lauderdale, FL
National Provider Identifier
1508216284
Registry record updated Jun 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
Practice address
1995 E Oakland Park Blvd
Suite 250
Fort Lauderdale, FL 33306-1147
Phone
(954) 791-6146
Fax
(954) 337-2733
NPI assigned
Jun 14, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X Primary

Addresses

Primary practice location

1995 E Oakland Park Blvd
Suite 250
Fort Lauderdale, FL 33306-1147

Mailing address

1995 E Oakland Park Blvd
Suite 250
Fort Lauderdale, FL 33306-1147
Phone (954) 791-6146

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ap of Nashville, LLC Past Accepting new patients
Florida Practitioners, LLC PastSince May 5, 2016 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1465862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465862400000",
    "number": "1508216284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1995 E OAKLAND PARK BLVD",
            "address_2": "SUITE 250",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333061147",
            "telephone_number": "954-791-6146",
            "fax_number": "954-337-2733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1995 E OAKLAND PARK BLVD",
            "address_2": "SUITE 250",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333061147",
            "telephone_number": "954-791-6146",
            "fax_number": "954-337-2733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARQUIN",
        "first_name": "JORGE",
        "credential": "CSA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-14",
        "last_updated": "2016-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2016; 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.