1700192762 NPI number — GARCIA & GARCIA MD S P A

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700192762 NPI number — GARCIA & GARCIA MD S P A

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GARCIA & GARCIA MD S P A
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1700192762
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/08/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
306 NE 19TH DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OKEECHOBEE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34972-1911
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
863-763-6427
Provider Business Mailing Address Fax Number:
863-763-0096

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8980 S US HIGHWAY 1
Provider Second Line Business Practice Location Address:
SUITE 106
Provider Business Practice Location Address City Name:
PORT ST LUCIE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34952-3482
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
772-337-5595
Provider Business Practice Location Address Fax Number:
863-763-0098
Provider Enumeration Date:
08/27/2010

Additional Information

Authorized Official

Authorized Official Last Name:
GARCIA
Authorized Official First Name:
TRINIDAD
Authorized Official Middle Name:
E
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
863-763-6427

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  ME0021723 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 053451000 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com