MEDICARE: JOSE FELIPE GARCIA-TRONCOSO MD

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	208600000X	Surgery Physician	8454	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ME63987	OTHER	FL	FLORIDA MEDICAL BOARD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417912130
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSE FELIPE GARCIA-TRONCOSO MD

Provider Business Mailing Address
First Line	:	PO BOX 1551
Second Line	:
City	:	VILLALBA
State	:	PR
Zip	:	00766-1551
Country	:	US
Telephone Number	:	787-847-1211
Fax Number	:	787-847-2672

Provider Business Practice Location Address
First Line	:	2223 W DR. MARTIN LUTHER KING JR. BLVD
Second Line	:	SUITE 101
City	:	TAMPA
State	:	FL
Zip	:	33607-0000
Country	:	US
Telephone Number	:	813-405-4385
Fax Number	:	813-405-4506

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

Provider Enumeration Date	:	04/18/2006
Last Update Date	:	05/17/2021

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