MEDICARE: LUIS M GARCIA, JR DPM

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	213E00000X	Podiatrist	1989072683	DE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2177920000	OTHER		KEYSTONE

General Provider Information

NPI Number	:	1740261551
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUIS M GARCIA, JR DPM

Provider Business Mailing Address
First Line	:	1941 LIMESTONE RD
Second Line	:	SUITE 208
City	:	WILMINGTON
State	:	DE
Zip	:	19808-5400
Country	:	US
Telephone Number	:	302-994-5956
Fax Number	:	302-994-9638

Provider Business Practice Location Address
First Line	:	1941 LIMESTONE RD
Second Line	:	SUITE 208
City	:	WILMINGTON
State	:	DE
Zip	:	19808-5400
Country	:	US
Telephone Number	:	302-994-5956
Fax Number	:	302-994-9638

Authorized Official
Title or Position	:	OWNER
Name	:	DR. LUIS M GARCIA JR.
Credential	:	DPM
Telephone Number	:	302-994-5956

Provider Enumeration Date	:	11/09/2005
Last Update Date	:	02/21/2024

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