Provider Demographics
NPI:1730501081
Name:JUAN M GARCES MD PA
Entity Type:Organization
Organization Name:JUAN M GARCES MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:GARCES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-251-4131
Mailing Address - Street 1:351 NW 42ND AVE
Mailing Address - Street 2:SUITE 503
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-5683
Mailing Address - Country:US
Mailing Address - Phone:305-444-1244
Mailing Address - Fax:305-642-7890
Practice Address - Street 1:14150 SW 119TH AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-6012
Practice Address - Country:US
Practice Address - Phone:305-251-4131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-06
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME45734332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site