Healthcare Provider Details

I. General information

NPI: 1477998953
Provider Name (Legal Business Name): DR. WILHELM GARCIA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2013
Last Update Date: 09/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3949 SW 8 ST
MIAMI FL
33134
US

IV. Provider business mailing address

8574 NW 165TH TER
MIAMI LAKES FL
33016-6139
US

V. Phone/Fax

Practice location:
  • Phone: 786-353-0107
  • Fax:
Mailing address:
  • Phone: 796-873-9645
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License NumberPU6012
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS40288
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: