Healthcare Provider Details
I. General information
NPI: 1275269706
Provider Name (Legal Business Name): AUBERTO GARCIA MHTC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/27/2022
Last Update Date: 07/27/2022
Certification Date: 07/27/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1250 SW 27TH AVE STE 506
MIAMI FL
33135-4751
US
IV. Provider business mailing address
1250 SW 27TH AVE STE 506
MIAMI FL
33135-4751
US
V. Phone/Fax
- Phone: 786-536-9278
- Fax: 786-536-5185
- Phone: 786-536-9278
- Fax: 786-536-5185
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 374700000X |
| Taxonomy | Technician |
| License Number | MHTC-0754 |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 374700000X |
| Taxonomy | Technician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: