Healthcare Provider Details

I. General information

NPI: 1083400543
Provider Name (Legal Business Name): ADONIS OTONIEL GARCIA GARCIA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ADONIS GARCIA

II. Dates (important events)

Enumeration Date: 04/18/2025
Last Update Date: 04/18/2025
Certification Date: 04/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 E CAPITOL ST NE
WASHINGTON DC
20003-1622
US

IV. Provider business mailing address

501 SCHOOL ST SW
WASHINGTON DC
20024-2754
US

V. Phone/Fax

Practice location:
  • Phone: 202-698-4500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: