Provider Demographics
NPI:1467075242
Name:GARCIA, ROLDAN JR
Entity Type:Individual
Prefix:
First Name:ROLDAN
Middle Name:
Last Name:GARCIA
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 E 13TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-3539
Mailing Address - Country:US
Mailing Address - Phone:786-516-3776
Mailing Address - Fax:
Practice Address - Street 1:325 E 13TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-3539
Practice Address - Country:US
Practice Address - Phone:786-516-3776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-27
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator