Provider Demographics
NPI:1831303643
Name:GARCIA, JORGE R (OD)
Entity Type:Individual
Prefix:DR
First Name:JORGE
Middle Name:R
Last Name:GARCIA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17118 SW 138TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-2189
Mailing Address - Country:US
Mailing Address - Phone:786-247-1194
Mailing Address - Fax:
Practice Address - Street 1:17118 SW 138TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-2189
Practice Address - Country:US
Practice Address - Phone:786-247-1194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 3342152W00000X
NY5988 TUV152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist