Healthcare Provider Details

I. General information

NPI: 1689924912
Provider Name (Legal Business Name): ALVARO GARCIA MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2012
Last Update Date: 09/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 N FLAMINGO RD SUITE 309
PEMBROKE PINES FL
33028-1015
US

IV. Provider business mailing address

16286 ERIE PL
DAVIE FL
33331-2118
US

V. Phone/Fax

Practice location:
  • Phone: 954-369-5511
  • Fax: 954-323-5554
Mailing address:
  • Phone: 954-369-5511
  • Fax: 954-323-5554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME93068
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License NumberME93068
License Number StateFL

VIII. Authorized Official

Name: ALVARO JUAN GARCIA
Title or Position: PRESIDENT/PROVIDER
Credential: MD
Phone: 954-369-5511