Provider Demographics
NPI:1760675268
Name:GARCIA, ROMAN JOSE (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:ROMAN
Middle Name:JOSE
Last Name:GARCIA
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 NW 183RD ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-4516
Mailing Address - Country:US
Mailing Address - Phone:305-653-6663
Mailing Address - Fax:305-652-3616
Practice Address - Street 1:7 NW 183RD ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-4516
Practice Address - Country:US
Practice Address - Phone:305-653-6663
Practice Address - Fax:305-652-3616
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-20
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT15157225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist