Provider Demographics
NPI:1871696328
Name:LLAMBES, JORGE LUIS (DO)
Entity type:Individual
Prefix:DR
First Name:JORGE
Middle Name:LUIS
Last Name:LLAMBES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1227 SHANNON CT
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-2384
Mailing Address - Country:US
Mailing Address - Phone:651-738-9663
Mailing Address - Fax:
Practice Address - Street 1:934ASTS/CC
Practice Address - Street 2:760 MILITARY, MSP-IAP, ARS
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55450-2100
Practice Address - Country:US
Practice Address - Phone:612-713-1616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN28656207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine