Healthcare Provider Details

I. General information

NPI: 1467440586
Provider Name (Legal Business Name): CHRISTOPHER GERARD GARCIA P.A.-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2005
Last Update Date: 10/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 N KENDALL DR
MIAMI FL
33176-2118
US

IV. Provider business mailing address

8900 N KENDALL DR
MIAMI FL
33176-2118
US

V. Phone/Fax

Practice location:
  • Phone: 786-596-2000
  • Fax: 305-279-7778
Mailing address:
  • Phone: 786-596-2000
  • Fax: 305-279-7778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA9103155
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: