Healthcare Provider Details

I. General information

NPI: 1265998975
Provider Name (Legal Business Name): JONATHAN GARCES DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2019
Last Update Date: 08/10/2022
Certification Date: 08/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4826 SW 49TH RD
OCALA FL
34474-6299
US

IV. Provider business mailing address

4909 SW 56TH ST
OCALA FL
34474-4754
US

V. Phone/Fax

Practice location:
  • Phone: 352-369-3320
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS18415
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: