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General NPI Number Information
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NPI Number | 1922105600
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Entity Type | Individual
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Provider Name | JUAN PHILLIP GARCIA MD
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Gender | Male
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Dates
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Enumeration Date | 09/17/2006
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Last Update Date | 07/29/2015
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Provider Practice Location Address
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Address Line | 700 3RD STREET SUITE 102
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City | NEPTUNE BEACH
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State | FL
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Zip | 32266
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Country | US
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Telephone | 904-247-8522
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Fax | 904-247-9722
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Provider Business Mailing Address
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Address Line | 700 3RD STREET SUITE 102
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City | NEPTUNE BEACH
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State | FL
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Zip | 32266
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Country | US
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Telephone | 904-247-8522
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Fax | 904-247-9722
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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 | 2082S0099X
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Taxonomy Name | Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
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License Number | ME77632
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License Number State | FL
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