Healthcare Provider Details

I. General information

NPI: 1285528745
Provider Name (Legal Business Name): JORGE ENRIQUE GARCIA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2025
Last Update Date: 06/06/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

717 W 32ND ST
HIALEAH FL
33012-5343
US

IV. Provider business mailing address

717 W 32ND ST
HIALEAH FL
33012-5343
US

V. Phone/Fax

Practice location:
  • Phone: 305-833-9080
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN9550977
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: