Provider Demographics
NPI:1518924729
Name:GARCIA-RIVERA, CARLOS ANDRES (DO)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:ANDRES
Last Name:GARCIA-RIVERA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9240 SW 72ND ST STE 118
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3262
Mailing Address - Country:US
Mailing Address - Phone:305-229-9899
Mailing Address - Fax:786-431-2844
Practice Address - Street 1:9240 SW 72ND ST
Practice Address - Street 2:SUITE 118
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3261
Practice Address - Country:US
Practice Address - Phone:305-229-9899
Practice Address - Fax:786-431-2844
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-01
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS85662084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE7374YOtherMEDICARE PTAN
FLH61081Medicare UPIN