Healthcare Provider Details

I. General information

NPI: 1184674244
Provider Name (Legal Business Name): JOEL RICHARD GARCIA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 12/13/2021
Certification Date: 12/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 FOWLER GROVE BLVD FL 3
WINTER GARDEN FL
34787-5050
US

IV. Provider business mailing address

2000 FOWLER GROVE BLVD FL 3
WINTER GARDEN FL
34787-5050
US

V. Phone/Fax

Practice location:
  • Phone: 407-889-1966
  • Fax: 407-889-1904
Mailing address:
  • Phone: 407-889-1966
  • Fax: 407-889-1904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RA0001X
TaxonomyAdvanced Heart Failure and Transplant Cardiology Physician
License NumberME93822
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME93822
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: