Healthcare Provider Details

I. General information

NPI: 1811887250
Provider Name (Legal Business Name): JOHANNA CAROLINA GARCIA VILLAMIZAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2025
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

874 CALLE FERNANDEZ JUNCOS N
CAROLINA PR
00985-6016
US

IV. Provider business mailing address

15965 SW 140TH ST
MIAMI FL
33196-6467
US

V. Phone/Fax

Practice location:
  • Phone: 787-621-3322
  • Fax:
Mailing address:
  • Phone: 786-603-8574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number025184
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: