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General NPI Number Information
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NPI Number | 1174942536
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Entity Type | Organization
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Legal Business Name | MG CARE, LLC
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Dates
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Enumeration Date | 04/14/2014
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Last Update Date | 10/15/2020
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Provider Practice Location Address
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Address Line | 175 FONTAINEBLEAU BLVD STE 1R10
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City | MIAMI
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State | FL
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Zip | 33172-4511
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Country | US
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Telephone | 305-909-9104
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Fax | 813-567-2400
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Provider Business Mailing Address
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Address Line | 1600 SW 145TH AVE
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City | MIAMI
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State | FL
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Zip | 33175-7469
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Country | US
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Telephone | 305-343-0673
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Fax | 813-567-2400
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MAXIMILLIAN ADRIAN GARCIA
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Credential | BA
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Telephone | 305-343-0673
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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