Provider Demographics
NPI:1285636613
Name:GARCIA-ESTRADA, HERMINIO (MD)
Entity Type:Individual
Prefix:DR
First Name:HERMINIO
Middle Name:
Last Name:GARCIA-ESTRADA
Suffix:
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 1:2601 SW 37TH AVE
Mailing Address - Street 2:SUITE 803
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-2700
Mailing Address - Country:US
Mailing Address - Phone:305-441-2656
Mailing Address - Fax:305-441-7864
Practice Address - Street 1:2601 SW 37TH AVE
Practice Address - Street 2:SUITE 803
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-2700
Practice Address - Country:US
Practice Address - Phone:305-441-2656
Practice Address - Fax:305-441-7864
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME25073207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD79535Medicare UPIN