Provider Demographics
NPI:1790420248
Name:GARCIA, JAVIER JOSE
Entity Type:Individual
Prefix:
First Name:JAVIER
Middle Name:JOSE
Last Name:GARCIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11200 SW 8TH STREET
Mailing Address - Street 2:AHC2
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33199
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11200 SW 8TH STREET
Practice Address - Street 2:AHC2
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33199
Practice Address - Country:US
Practice Address - Phone:305-310-3211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-29
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program