MEDICARE: JAIMIE GARCIA

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	104100000X	Social Worker	19046	PR

General Provider Information

NPI Number	:	1366860678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAIMIE GARCIA

Provider Business Mailing Address
First Line	:	BARRIO SAN ANTON BUZON 151
Second Line	:
City	:	PONCE
State	:	PR
Zip	:	00717
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4066 CALLE SANTA CATALINA
Second Line	:	URB. SANTA TERESITA
City	:	PONCE
State	:	PR
Zip	:	00730-4620
Country	:	US
Telephone Number	:	787-610-3045
Fax Number	:

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

Provider Enumeration Date	:	04/03/2014
Last Update Date	:	04/03/2014

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Directions to “ JAIMIE GARCIA ” Practice Location

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