Provider Demographics
NPI:1275604571
Name:GARCIA, PETE SR (MD)
Entity Type:Individual
Prefix:MR
First Name:PETE
Middle Name:
Last Name:GARCIA
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7800 SW 87TH AVE STE A-110
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3570
Mailing Address - Country:US
Mailing Address - Phone:305-856-8445
Mailing Address - Fax:305-856-6388
Practice Address - Street 1:7800 SW 87TH AVE STE A-110
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3570
Practice Address - Country:US
Practice Address - Phone:305-856-8445
Practice Address - Fax:305-856-6388
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME60071174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL054231800Medicaid
FLE95700Medicare UPIN