Provider Demographics
NPI:1619973807
Name:GARCES, JUAN M (MD)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:M
Last Name:GARCES
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 1:6600 COW PEN RD STE 100
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-7618
Mailing Address - Country:US
Mailing Address - Phone:786-453-9803
Mailing Address - Fax:783-472-8921
Practice Address - Street 1:6600 COW PEN RD STE 100
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-7618
Practice Address - Country:US
Practice Address - Phone:786-453-9803
Practice Address - Fax:783-472-8921
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2021-11-24
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-05-24
Provider Licenses
StateLicense IDTaxonomies
FLME0045734174400000X
FLME45734207RE0101X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No174400000XOther Service ProvidersSpecialist
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL045397800Medicaid