Healthcare Provider Details

I. General information

NPI: 1023180171
Provider Name (Legal Business Name): OSCAR VICENTE GARCIA DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15501 NW 67TH AVE STE 201
MIAMI LAKES FL
33014-2123
US

IV. Provider business mailing address

15501 NW 67TH AVE STE 201
MIAMI LAKES FL
33014-2123
US

V. Phone/Fax

Practice location:
  • Phone: 305-823-8831
  • Fax: 786-577-4968
Mailing address:
  • Phone: 305-823-8831
  • Fax: 786-577-4968

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number21057
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDN16341
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: