Healthcare Provider Details

I. General information

NPI: 1205368859
Provider Name (Legal Business Name): JUAN GARCES MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2017
Last Update Date: 04/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14150 SW 119TH AVE SUITE 102
MIAMI FL
33186-6012
US

IV. Provider business mailing address

351 NW 42ND AVE SUITE 503
MIAMI FL
33126-5683
US

V. Phone/Fax

Practice location:
  • Phone: 305-251-4131
  • Fax:
Mailing address:
  • Phone: 305-444-1244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME45734
License Number StateFL

VIII. Authorized Official

Name: DR. JUAN M GARCES
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 305-251-4131