Healthcare Provider Details

I. General information

NPI: 1932486248
Provider Name (Legal Business Name): JAIME GARCIA, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2011
Last Update Date: 11/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

935 W 49TH ST SUITE 107
HIALEAH FL
33012-3436
US

IV. Provider business mailing address

935 W 49TH ST SUITE 107
HIALEAH FL
33012-3436
US

V. Phone/Fax

Practice location:
  • Phone: 305-827-2268
  • Fax:
Mailing address:
  • Phone: 305-827-2268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberME0067819
License Number StateFL

VIII. Authorized Official

Name: MR. GONZALO ESTEVEZ V
Title or Position: ADMINISTRATOR
Credential: MBA
Phone: 305-827-2489