MEDICARE: ALEJANDRO GARCIA PTA

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
1	225200000X	Physical Therapy Assistant	30126	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1194313759
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEJANDRO GARCIA PTA

Provider Business Mailing Address
First Line	:	11820 SW 190TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33177-3941
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 WEST AVE APT 1411
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33139-4728
Country	:	US
Telephone Number	:	305-778-9198
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2021
Last Update Date	:	05/13/2022

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Directions to “ ALEJANDRO GARCIA PTA” Practice Location

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