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General NPI Number Information
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NPI Number | 1437721941
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Entity Type | Individual
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Provider Name | JAVIER GARCIA
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Gender | Male
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Dates
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Enumeration Date | 07/14/2021
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Last Update Date | 11/07/2023
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Provider Practice Location Address
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Address Line | 196 THOMAS JOHNSON DR STE 120
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City | FREDERICK
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State | MD
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Zip | 21702-4521
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Country | US
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Telephone | 240-556-3130
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Fax |
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Provider Business Mailing Address
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Address Line | 5850 CAMERON RUN TER APT 605
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City | ALEXANDRIA
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State | VA
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Zip | 22303-2721
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Country | US
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Telephone | 240-559-7337
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AC005979
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License Number State | MD
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