MEDICARE: NICOLE GARCIA AP, D.O.M.

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	171100000X	Acupuncturist	AP3002	FL

General Provider Information

NPI Number	:	1972874568
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE GARCIA AP, D.O.M.

Provider Business Mailing Address
First Line	:	3042 N FEDERAL HWY
Second Line	:	SUITE 200
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33306-1400
Country	:	US
Telephone Number	:	954-568-4470
Fax Number	:

Provider Business Practice Location Address
First Line	:	3042 N FEDERAL HWY
Second Line	:	SUITE 200
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33306-1400
Country	:	US
Telephone Number	:	954-568-4470
Fax Number	:

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

Provider Enumeration Date	:	01/13/2012
Last Update Date	:	01/13/2012

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