Healthcare Provider Details

I. General information

NPI: 1346311016
Provider Name (Legal Business Name): MARIA M GARCIA TECHNOLOGIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11460 INTERCHANGE CIRCLE NORTH
MIRAMAR FL
33025-6005
US

IV. Provider business mailing address

11460 INTERCHANGE CIRCLE NORTH
MIRAMAR FL
33025-6005
US

V. Phone/Fax

Practice location:
  • Phone: 954-430-4424
  • Fax: 954-430-4412
Mailing address:
  • Phone: 954-430-4424
  • Fax: 954-430-4412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246QM0706X
TaxonomyMedical Technologist
License NumberTN38355
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: