Provider Demographics
NPI:1427397090
Name:GARCES, LUIS ALFONSO (LPTA)
Entity Type:Individual
Prefix:MR
First Name:LUIS
Middle Name:ALFONSO
Last Name:GARCES
Suffix:
Gender:M
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 PONDELLA RD APT 813
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33909-5175
Mailing Address - Country:US
Mailing Address - Phone:239-458-2184
Mailing Address - Fax:239-458-2184
Practice Address - Street 1:1100 PONDELLA RD APT 813
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33909-5175
Practice Address - Country:US
Practice Address - Phone:239-458-2184
Practice Address - Fax:239-458-2184
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-01
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA20731225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant