MEDICARE: DR. NICHOLAS ALBERT GARCIA M.D.

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	390200000X	Student in an Organized Health Care Education/Training Program
2	2086S0122X	Plastic and Reconstructive Surgery Physician	ME162089	FL

General Provider Information

NPI Number	:	1306231345
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICHOLAS ALBERT GARCIA M.D.

Provider Business Mailing Address
First Line	:	3731 BLUE HERON DR
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33908-4109
Country	:	US
Telephone Number	:	305-467-4767
Fax Number	:

Provider Business Practice Location Address
First Line	:	12998 S CLEVELAND AVE
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-3849
Country	:	US
Telephone Number	:	239-482-1900
Fax Number	:

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

Provider Enumeration Date	:	04/06/2015
Last Update Date	:	08/13/2024

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