Healthcare Provider Details

I. General information

NPI: 1306839063
Provider Name (Legal Business Name): HUMBERTO GARCIA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2005
Last Update Date: 09/13/2021
Certification Date: 09/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11501 SW 40TH ST
MIAMI FL
33165-3313
US

IV. Provider business mailing address

8600 NW 41ST ST
DORAL FL
33166-6202
US

V. Phone/Fax

Practice location:
  • Phone: 787-766-2223
  • Fax:
Mailing address:
  • Phone: 305-642-5366
  • Fax: 305-631-3803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME95189
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: