MEDICARE: RAFAEL 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	207R00000X	Internal Medicine Physician	ME94853	FL
2	207R00000X	Internal Medicine Physician	35094046	OH

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720020787
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAFAEL GARCIA M.D.

Provider Business Mailing Address
First Line	:	30033 CLEMENS RD
Second Line	:
City	:	WESTLAKE
State	:	OH
Zip	:	44145-1021
Country	:	US
Telephone Number	:	440-899-5555
Fax Number	:

Provider Business Practice Location Address
First Line	:	30033 CLEMENS RD
Second Line	:
City	:	WESTLAKE
State	:	OH
Zip	:	44145-1021
Country	:	US
Telephone Number	:	440-899-5555
Fax Number	:

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

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	02/01/2011

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