Healthcare Provider Details

I. General information

NPI: 1831623289
Provider Name (Legal Business Name): ALEXANDRA NASTASSIA GARCIA GLINOS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALEXANDRA NASTASSIA GARCIA M.D.

II. Dates (important events)

Enumeration Date: 04/12/2017
Last Update Date: 08/22/2024
Certification Date: 08/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8940 N KENDALL DR STE 701E
MIAMI FL
33176-2100
US

IV. Provider business mailing address

5861 SW 89TH CT
MIAMI FL
33173-1695
US

V. Phone/Fax

Practice location:
  • Phone: 786-534-8884
  • Fax:
Mailing address:
  • Phone: 786-253-1625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License NumberME168836
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: