Healthcare Provider Details

I. General information

NPI: 1730875345
Provider Name (Legal Business Name): MICHAEL GARCIA DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2023
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

931 W OAK ST STE 103
KISSIMMEE FL
34741-4973
US

IV. Provider business mailing address

931 W OAK ST STE 103
KISSIMMEE FL
34741-4973
US

V. Phone/Fax

Practice location:
  • Phone: 407-931-0444
  • Fax: 407-962-4446
Mailing address:
  • Phone: 407-931-0444
  • Fax: 407-962-4446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS23991
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: