Healthcare Provider Details

I. General information

NPI: 1154112845
Provider Name (Legal Business Name): VICTOR MOISES GARCIA AUD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2025
Last Update Date: 05/30/2026
Certification Date: 05/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7820 PETERS RD STE E103
PLANTATION FL
33324-4019
US

IV. Provider business mailing address

7820 PETERS RD STE E103
PLANTATION FL
33324-4019
US

V. Phone/Fax

Practice location:
  • Phone: 954-961-3456
  • Fax:
Mailing address:
  • Phone: 954-961-3456
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAY2921
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: