Tibbar Medical PLLC

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

ME 66752 Issued in FL

Legal business name

TIBBAR MEDICAL PLLC

Practice address

401 Miracle Mile
Suite 103
Coral Gables, FL 33134

Phone

(305) 962-8375

NPI assigned

Apr 4, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Jackeline T Gomez Jorge, MD

Title

Manager

Phone

(305) 962-8375

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1301875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484265600000",
    "number": "1730478348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 MIRACLE MILE",
            "address_2": "SUITE 103",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "33134",
            "telephone_number": "305-962-8375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 MIRACLE MILE",
            "address_2": "SUITE 103",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "33134",
            "telephone_number": "305-962-8375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIBBAR MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-04",
        "last_updated": "2017-01-13",
        "status": "A",
        "authorized_official_last_name": "GOMEZ JORGE",
        "authorized_official_first_name": "JACKELINE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "305-962-8375",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "FL",
            "license": "ME 66752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Vascular & Interventional Radiology Physician in Coral Gables, FL
• Providers in Coral Gables, FL by specialty
• Vascular & Interventional Radiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2017; 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.