Healthcare Provider Details

I. General information

NPI: 1598288573
Provider Name (Legal Business Name): JULIO CESAR GARCIA FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2017
Last Update Date: 07/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

651 E 25TH ST
HIALEAH FL
33013-3814
US

IV. Provider business mailing address

2631 SW 112TH CT
MIAMI FL
33165-2273
US

V. Phone/Fax

Practice location:
  • Phone: 305-693-6100
  • Fax: 305-693-6100
Mailing address:
  • Phone: 305-725-3301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9357917
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: