Provider Demographics
NPI:1497174981
Name:GARCIA-JUARBE MEDICAL
Entity Type:Organization
Organization Name:GARCIA-JUARBE MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IXSA
Authorized Official - Middle Name:TANYA
Authorized Official - Last Name:GARCIA-JUARBE
Authorized Official - Suffix:
Authorized Official - Credentials:DO, DPM
Authorized Official - Phone:954-592-0898
Mailing Address - Street 1:1473 SW 116TH AVE
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33025-3771
Mailing Address - Country:US
Mailing Address - Phone:954-592-0898
Mailing Address - Fax:
Practice Address - Street 1:1473 SW 116TH AVE
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33025-3771
Practice Address - Country:US
Practice Address - Phone:954-592-0898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-10
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS12430207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty