Healthcare Provider Details

I. General information

NPI: 1164410676
Provider Name (Legal Business Name): JORGE E GARCIA FERRERAS DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2005
Last Update Date: 02/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9410 AVE LOS ROMEROS MONTEHIEDRA TOWN CENTER SUITE 204
SAN JUAN PR
00926-7007
US

IV. Provider business mailing address

A7 CALLE 2 MANSIONES GARDEN HILLS
GUAYNABO PR
00966-2717
US

V. Phone/Fax

Practice location:
  • Phone: 787-473-3880
  • Fax: 787-789-3790
Mailing address:
  • Phone: 787-473-3880
  • Fax: 787-789-3790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number100
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: