Provider Demographics
NPI:1689645921
Name:URDANETA-JAIMES, JOSE ANTONIO (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:ANTONIO
Last Name:URDANETA-JAIMES
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1121 N CENTRAL AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-4405
Mailing Address - Country:US
Mailing Address - Phone:407-933-1221
Mailing Address - Fax:407-933-0747
Practice Address - Street 1:1121 N CENTRAL AVE
Practice Address - Street 2:SUITE B
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4405
Practice Address - Country:US
Practice Address - Phone:407-933-1221
Practice Address - Fax:407-933-0747
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2021-11-02
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Provider Licenses
StateLicense IDTaxonomies
FLME84353207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease