Healthcare Provider Details

I. General information

NPI: 1073971024
Provider Name (Legal Business Name): JOHAN GARCIA RODRIGUEZ ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2016
Last Update Date: 11/27/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 SW 57TH AVE SUITE 210
WEST MIAMI FL
33144-5775
US

IV. Provider business mailing address

8181 NW 154TH ST SUITE 200
MIAMI LAKES FL
33016-5881
US

V. Phone/Fax

Practice location:
  • Phone: 305-441-0744
  • Fax: 305-262-8771
Mailing address:
  • Phone: 305-558-3724
  • Fax: 786-260-0019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9388776
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: