MEDICARE: MR. WALTER HUMBERTO GARCIA RRT

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	2279C0205X	Critical Care Registered Respiratory Therapist	RT1480	FL

General Provider Information

NPI Number	:	1770799686
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WALTER HUMBERTO GARCIA RRT

Provider Business Mailing Address
First Line	:	240 CHEROKEE ST
Second Line	:
City	:	MIAMI SPRINGS
State	:	FL
Zip	:	33166-5115
Country	:	US
Telephone Number	:	305-884-1499
Fax Number	:

Provider Business Practice Location Address
First Line	:	240 CHEROKEE ST
Second Line	:
City	:	MIAMI SPRINGS
State	:	FL
Zip	:	33166-5115
Country	:	US
Telephone Number	:	305-884-1499
Fax Number	:

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

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	07/08/2007

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