Provider Demographics
NPI:1750508966
Name:GARCIA, FELIPE ANTONIO SR (FELIPE GARCIA)
Entity Type:Individual
Prefix:DR
First Name:FELIPE
Middle Name:ANTONIO
Last Name:GARCIA
Suffix:SR
Gender:M
Credentials:FELIPE GARCIA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:66 CALLE SANTA CRUZ
Mailing Address - Street 2:405
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-7041
Mailing Address - Country:US
Mailing Address - Phone:787-269-3990
Mailing Address - Fax:787-269-4070
Practice Address - Street 1:66 CALLE SANTA CRUZ
Practice Address - Street 2:405
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-7041
Practice Address - Country:US
Practice Address - Phone:787-269-3990
Practice Address - Fax:787-269-4070
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6144207RC0000X, 207RC0200X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0097549Medicare ID - Type Unspecified
PRD08727Medicare UPIN