MEDICARE: MANUEL A GARCIA HERRAN MD

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	207R00000X	Internal Medicine Physician	ME72070	FL
2	207QA0505X	Adult Medicine Physician	ME72070	FL

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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962504795
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANUEL A GARCIA HERRAN MD

Provider Business Mailing Address
First Line	:	31 NE 27TH DR
Second Line	:
City	:	WILTON MANORS
State	:	FL
Zip	:	33334-1071
Country	:	US
Telephone Number	:	954-555-1190
Fax Number	:

Provider Business Practice Location Address
First Line	:	1850 NE 163RD ST
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-4867
Country	:	US
Telephone Number	:	305-882-9323
Fax Number	:	786-916-2986

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

Provider Enumeration Date	:	09/02/2006
Last Update Date	:	08/19/2022

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