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General NPI Number Information
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NPI Number | 1942548987
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Entity Type | Individual
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Provider Name | JOHAN ISAIAH GAREL P.A.
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Gender | Male
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Dates
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Enumeration Date | 01/25/2013
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Last Update Date | 01/25/2013
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Provider Practice Location Address
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Address Line | 3908 S STATE ROAD 7
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City | MIRAMAR
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State | FL
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Zip | 33023-6162
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Country | US
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Telephone | 954-394-5678
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 693332
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City | MIAMI
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State | FL
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Zip | 33269-0332
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Country | US
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Telephone |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9106448
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License Number State | FL
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