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General NPI Number Information
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NPI Number | 1184895088
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Entity Type | Organization
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Legal Business Name | BERNARDO R GARCIA-GRANDA MD PA
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Dates
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Enumeration Date | 03/18/2008
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Last Update Date | 07/29/2008
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Provider Practice Location Address
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Address Line | 11760 BIRD RD SUITE 539
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City | MIAMI
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State | FL
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Zip | 33175-3582
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Country | US
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Telephone | 305-228-6200
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Fax | 305-228-1314
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Provider Business Mailing Address
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Address Line | 11760 BIRD RD SUITE 539
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City | MIAMI
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State | FL
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Zip | 33175-3582
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Country | US
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Telephone | 305-228-6200
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BERNARDO R. GARCIA-GRANDA
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Credential | M.D.
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Telephone | 305-228-6200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME34067
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License Number State | FL
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