=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154923399
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | EMMANUEL HUNT GARCIA RRT
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/12/2020
-----------------------------------------------------
Last Update Date | 11/12/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9509 WILLARD AVE
-----------------------------------------------------
City | CLEVELAND
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44102-3741
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-255-0406
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9509 WILLARD AVE
-----------------------------------------------------
City | CLEVELAND
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44102-3741
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-255-0406
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2278P1005X
-----------------------------------------------------
Taxonomy Name | Pulmonary Rehabilitation Certified Respiratory Therapist
-----------------------------------------------------
License Number | RCP.14348
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------