Healthcare Provider Details

I. General information

NPI: 1750508966
Provider Name (Legal Business Name): FELIPE ANTONIO GARCIA SR. FELIPE GARCIA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 02/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 CALLE SANTA CRUZ 405
BAYAMON PR
00961-7041
US

IV. Provider business mailing address

66 CALLE SANTA CRUZ 405
BAYAMON PR
00961-7041
US

V. Phone/Fax

Practice location:
  • Phone: 787-269-3990
  • Fax: 787-269-4070
Mailing address:
  • Phone: 787-269-3990
  • Fax: 787-269-4070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number6144
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number6144
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number6144
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: