Healthcare Provider Details

I. General information

NPI: 1760441869
Provider Name (Legal Business Name): CARLOS M GARCIA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 09/11/2020
Certification Date: 09/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 MITYLENE PARK LN
MONTGOMERY AL
36117-7302
US

IV. Provider business mailing address

3081 GREEN FOREST CT
MILLBROOK AL
36054-3927
US

V. Phone/Fax

Practice location:
  • Phone: 334-387-9940
  • Fax: 343-870-9553
Mailing address:
  • Phone: 334-387-3994
  • Fax: 334-387-0955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number14853
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: