1679819320 NPI number — ROBERTO N GARCIA RRT

Table of content: ROBERTO N GARCIA RRT (NPI 1679819320)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679819320 NPI number — ROBERTO N GARCIA RRT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GARCIA
Provider First Name:
ROBERTO
Provider Middle Name:
N
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RRT
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1679819320
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/28/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14837 BALGOWAN RD
Provider Second Line Business Mailing Address:
202
Provider Business Mailing Address City Name:
MIAMI LAKES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33016-6472
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-206-5830
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14837 BALGOWAN RD
Provider Second Line Business Practice Location Address:
202
Provider Business Practice Location Address City Name:
MIAMI LAKES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33016-6472
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-206-5830
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/28/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2279P1004X , with the licence number:  RT 12334 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2279P1006X , with the licence number: RT 12334 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 227900000X , with the licence number: RT12334 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2279P1005X , with the licence number: RRT 12334 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2279P4000X , with the licence number: RRT12334 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2279S1500X , with the licence number: RRT 12334 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)