Healthcare Provider Details

I. General information

NPI: 1497099899
Provider Name (Legal Business Name): JAMES ANDREW GARCIA HAS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2012
Last Update Date: 11/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 N BYRON BUTLER PKWY
PERRY FL
32347-2315
US

IV. Provider business mailing address

600 VICTORY GARDEN DR APT M 105
TALLAHASSEE FL
32301-3262
US

V. Phone/Fax

Practice location:
  • Phone: 850-584-3277
  • Fax:
Mailing address:
  • Phone: 850-567-5009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberAS-4755
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: