Healthcare Provider Details

I. General information

NPI: 1154571560
Provider Name (Legal Business Name): JUAN CARLOS GARCIA MORELL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2008
Last Update Date: 02/20/2024
Certification Date: 02/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 PINELLAS ST STE 400
CLEARWATER FL
33756-3356
US

IV. Provider business mailing address

455 PINELLAS ST STE 400
CLEARWATER FL
33756-3356
US

V. Phone/Fax

Practice location:
  • Phone: 727-445-1911
  • Fax: 727-445-1986
Mailing address:
  • Phone: 727-445-1911
  • Fax: 727-445-1986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME127898
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberME127898
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: