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General NPI Number Information
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NPI Number | 1043682826
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Entity Type | Individual
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Provider Name | IVAN RAFAEL GARCIA MARTINEZ ARNP
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Gender | Male
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Dates
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Enumeration Date | 10/20/2015
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Last Update Date | 04/19/2024
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Provider Practice Location Address
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Address Line | 5378 W 16TH AVE
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City | HIALEAH
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State | FL
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Zip | 33012-2165
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Country | US
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Telephone | 305-820-4101
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Fax |
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Provider Business Mailing Address
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Address Line | 5378 W 16TH AVE
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City | HIALEAH
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State | FL
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Zip | 33012-2165
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Country | US
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Telephone | 305-820-4101
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Fax | 305-820-2885
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN 9370031
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP 9370031
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License Number State | FL
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