Healthcare Provider Details

I. General information

NPI: 1821694373
Provider Name (Legal Business Name): ANTONIO GARCIA HERRERO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/09/2020
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18430 S DIXIE HWY STE 101
CUTLER BAY FL
33157-6816
US

IV. Provider business mailing address

PO BOX 4189
DEERFIELD BEACH FL
33442-4189
US

V. Phone/Fax

Practice location:
  • Phone: 305-253-0040
  • Fax: 305-253-0177
Mailing address:
  • Phone: 954-363-9582
  • Fax: 954-363-9663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11010557
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: