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NPI Code Detail

MEDICARE: MARA ELENA DE GARCIA MD PA

MEDICARE: MARA ELENA DE GARCIA MD PA
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
1207Q00000XFamily Medicine PhysicianME 34210FL

General Provider Information

NPI Number : 1790058253
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARA ELENA DE GARCIA MD PA
Provider Business Mailing Address
First Line : 1562 WASHINGTON AVE
Second Line :
City : MIAMI BEACH
State : FL
Zip : 33139-7801
Country : US
Telephone Number : 305-531-4186
Fax Number : 305-674-0159
Provider Business Practice Location Address
First Line : 1562 WASHINGTON AVE
Second Line :
City : MIAMI BEACH
State : FL
Zip : 33139-7801
Country : US
Telephone Number : 305-531-4186
Fax Number : 305-674-0159
Authorized Official
Title or Position : PRESIDENT
Name : MARA ELENA DE GARCIA
Credential : MD
Telephone Number : 305-531-4186
Provider Enumeration Date : 02/14/2012
Last Update Date : 06/18/2012

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