Healthcare Provider Details

I. General information

NPI: 1275604571
Provider Name (Legal Business Name): PETE GARCIA SR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2006
Last Update Date: 04/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7800 SW 87TH AVE STE A-110
MIAMI FL
33173-3570
US

IV. Provider business mailing address

7800 SW 87TH AVE STE A-110
MIAMI FL
33173-3570
US

V. Phone/Fax

Practice location:
  • Phone: 305-856-8445
  • Fax: 305-856-6388
Mailing address:
  • Phone: 305-856-8445
  • Fax: 305-856-6388

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME60071
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: