Individual provider Active NPI

Jorge Luis Vega Morales, PA

  • Medical Physician Assistant
  • Miami, FL
National Provider Identifier
1891316105
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
002256-PA Issued in PR
Practice address
9495 SW 72ND St Ste B180
Miami, FL 33173-5424
Phone
(305) 274-5319
Fax
(305) 274-5320
NPI assigned
Apr 28, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 002256-PA PR Primary

Addresses

Primary practice location

9495 SW 72ND St Ste B180
Miami, FL 33173-5424

Mailing address

9495 SW 72ND St Ste B180
Miami, FL 33173-5424
Phone (305) 274-5319

Other practice location 1

2190 NW 2nd St
Miami, FL 33125-5326
Phone (305) 876-6463

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
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
002256-PAPRMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1588032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1891316105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9495 SW 72ND ST STE B180",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331735424",
            "telephone_number": "305-274-5319",
            "fax_number": "305-274-5320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9495 SW 72ND ST STE B180",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331735424",
            "telephone_number": "305-274-5319",
            "fax_number": "305-274-5320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2190 NW 2nd St",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331255326",
            "country_code": "US",
            "telephone_number": "305-876-6463",
            "fax_number": "786-744-6463",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VEGA MORALES",
        "first_name": "JORGE",
        "middle_name": "LUIS",
        "name_prefix": "Dr.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-28",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PR",
            "license": "002256-PA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; 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.