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NPI Code Detail

MEDICARE: ERIBERTO GARCIA PEACOK

MEDICARE:   ERIBERTO  GARCIA PEACOK
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
1246ZC0007XSurgical Assistant23-562FL

General Provider Information

NPI Number : 1124802772
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIBERTO GARCIA PEACOK
Provider Business Mailing Address
First Line : 2330 NW 11TH ST APT 33
Second Line :
City : MIAMI
State : FL
Zip : 33125-3238
Country : US
Telephone Number : 786-819-8736
Fax Number :
Provider Business Practice Location Address
First Line : 2330 NW 11TH ST APT 33
Second Line :
City : MIAMI
State : FL
Zip : 33125-3238
Country : US
Telephone Number : 786-819-8736
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2023
Last Update Date : 08/23/2023

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Directions to “ ERIBERTO GARCIA PEACOK ” Practice Location

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