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General NPI Number Information
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NPI Number | 1902550460
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Entity Type | Individual
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Provider Name | RACIEL ALONSO GARCIA APRN
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Gender | Male
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Dates
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Enumeration Date | 02/03/2022
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 1599 SE LENNARD RD
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City | PORT ST LUCIE
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State | FL
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Zip | 34952-6542
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Country | US
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Telephone | 772-323-0762
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Fax | 772-413-0045
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Provider Business Mailing Address
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Address Line | PO BOX 4189
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-4189
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Country | US
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Telephone | 954-363-9582
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Fax | 954-363-9663
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F022220136
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN11018353
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11018353
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License Number State | FL
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