MEDICARE: JAMIE GARCIA M.P.T.

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	225100000X	Physical Therapist	20239	FL

General Provider Information

NPI Number	:	1588662035
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMIE GARCIA M.P.T.

Provider Business Mailing Address
First Line	:	11380 PROSPERITY FARMS RD
Second Line	:	SUITE B-109
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-3474
Country	:	US
Telephone Number	:	561-803-7761
Fax Number	:	561-803-7762

Provider Business Practice Location Address
First Line	:	11380 PROSPERITY FARMS RD
Second Line	:	SUITE B-109
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-3474
Country	:	US
Telephone Number	:	561-803-7761
Fax Number	:	561-803-7762

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

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	07/08/2007

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