Healthcare Provider Details

I. General information

NPI: 1174170104
Provider Name (Legal Business Name): DR MICHEL BORMEY GARCIA PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2019
Last Update Date: 02/06/2026
Certification Date: 02/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3750 W 16TH AVE STE 238U
HIALEAH FL
33012-4665
US

IV. Provider business mailing address

3725 W FLAGLER ST # 301
CORAL GABLES FL
33134-1601
US

V. Phone/Fax

Practice location:
  • Phone: 786-398-1669
  • Fax:
Mailing address:
  • Phone: 786-398-1669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MICHEL BORMEY GARCIA
Title or Position: PHYSICIAN
Credential: MD
Phone: 786-398-1669