Provider Demographics
NPI:1669636452
Name:GARCIA FACIAL PLASTIC SURGERY INSTITUTE INC
Entity Type:Organization
Organization Name:GARCIA FACIAL PLASTIC SURGERY INSTITUTE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:F
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-247-8522
Mailing Address - Street 1:700 3RD ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:NEPTUNE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32266-5072
Mailing Address - Country:US
Mailing Address - Phone:904-247-8522
Mailing Address - Fax:904-247-9722
Practice Address - Street 1:700 3RD ST
Practice Address - Street 2:SUITE 102
Practice Address - City:NEPTUNE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32266-5072
Practice Address - Country:US
Practice Address - Phone:904-247-8522
Practice Address - Fax:904-247-9722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-11
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOSR513261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center