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General NPI Number Information
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NPI Number | 1609901792
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Entity Type | Individual
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Provider Name | NICOLE A GARCIA PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 03/29/2019
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Provider Practice Location Address
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Address Line | 13241 BARTRAM PARK BLVD UNIT 2601
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City | JACKSONVILLE
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State | FL
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Zip | 32258-5219
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Country | US
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Telephone | 904-298-1800
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Fax | 904-298-1802
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Provider Business Mailing Address
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Address Line | 13241 BARTRAM PARK BLVD UNIT 2601
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City | JACKSONVILLE
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State | FL
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Zip | 32258-5219
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Country | US
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Telephone | 904-298-1800
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Fax | 904-298-1802
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9104053
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License Number State | FL
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