Provider Demographics
NPI:1639534100
Name:GARCIA, FERNANDO (APRN)
Entity Type:Individual
Prefix:
First Name:FERNANDO
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4881 PALM BEACH BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33905-3217
Mailing Address - Country:US
Mailing Address - Phone:239-693-9191
Mailing Address - Fax:239-693-7369
Practice Address - Street 1:4881 PALM BEACH BLVD STE 100
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33905-3217
Practice Address - Country:US
Practice Address - Phone:239-693-9191
Practice Address - Fax:239-693-7369
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-28
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11006015363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily