Provider Demographics
NPI:1447602529
Name:IVONNE GARCIA
Entity Type:Organization
Organization Name:IVONNE GARCIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY TECH
Authorized Official - Prefix:
Authorized Official - First Name:IVONNE
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:305-984-2193
Mailing Address - Street 1:17324 SW 108TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-4004
Mailing Address - Country:US
Mailing Address - Phone:305-984-2193
Mailing Address - Fax:
Practice Address - Street 1:17324 SW 108TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-4004
Practice Address - Country:US
Practice Address - Phone:305-984-2193
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-12
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRPT51057333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy