Provider Demographics
NPI:1447218870
Name:GARCIA, BERNARD (MD)
Entity Type:Individual
Prefix:
First Name:BERNARD
Middle Name:
Last Name:GARCIA
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 1:4800 N FEDERAL HWY
Mailing Address - Street 2:200
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-4602
Mailing Address - Country:US
Mailing Address - Phone:954-771-2111
Mailing Address - Fax:954-771-7347
Practice Address - Street 1:4800 N FEDERAL HWY
Practice Address - Street 2:200
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-4608
Practice Address - Country:US
Practice Address - Phone:954-771-2111
Practice Address - Fax:954-771-7347
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME95281207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL41049ZMedicare PIN
FLI24917Medicare UPIN