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NPI Code Detail

MEDICARE: IVAN RAFAEL GARCIA MARTINEZ ARNP

MEDICARE:   IVAN RAFAEL GARCIA MARTINEZ  ARNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN 9370031FL
2363LF0000XFamily Nurse PractitionerARNP 9370031FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043682826
Entity Type Code : Individual
Provider Name (Legal Business Name) : IVAN RAFAEL GARCIA MARTINEZ ARNP
Provider Business Mailing Address
First Line : 5378 W 16TH AVE
Second Line :
City : HIALEAH
State : FL
Zip : 33012-2165
Country : US
Telephone Number : 305-820-4101
Fax Number : 305-820-2885
Provider Business Practice Location Address
First Line : 5378 W 16TH AVE
Second Line :
City : HIALEAH
State : FL
Zip : 33012-2165
Country : US
Telephone Number : 305-820-4101
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2015
Last Update Date : 04/19/2024

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