Healthcare Provider Details

I. General information

NPI: 1164719910
Provider Name (Legal Business Name): MERCEDES GARCIA ANP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2011
Last Update Date: 06/24/2020
Certification Date: 06/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7401 N UNIVERSITY DR STE 103
TAMARAC FL
33321-2933
US

IV. Provider business mailing address

18743 SW 24TH ST
MIRAMAR FL
33029-5934
US

V. Phone/Fax

Practice location:
  • Phone: 954-233-0913
  • Fax: 954-591-5011
Mailing address:
  • Phone: 954-233-0913
  • Fax: 954-391-5011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number9260510
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: