MEDICARE: MRS. NICOLE MARY GARCIA APRN - BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	1194903039	FL

General Provider Information

NPI Number	:	1194903039
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NICOLE MARY GARCIA APRN - BC

Provider Business Mailing Address
First Line	:	1617 MOUNT VERNON ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32803-5508
Country	:	US
Telephone Number	:	718-578-7508
Fax Number	:

Provider Business Practice Location Address
First Line	:	1617 MOUNT VERNON ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32803-5508
Country	:	US
Telephone Number	:	718-578-7508
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2008
Last Update Date	:	09/26/2025

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