Healthcare Provider Details

I. General information

NPI: 1700464294
Provider Name (Legal Business Name): MICHAEL GARCIA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2021
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 GREYSTONE POWER BLVD STE 100
DALLAS GA
30157-8297
US

IV. Provider business mailing address

11991 SW 118TH ST
MIAMI FL
33186-5109
US

V. Phone/Fax

Practice location:
  • Phone: 678-945-8345
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number105508
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: