Provider Demographics
NPI:1841801685
Name:BELTRAN GARCES, DAMIAN (PA, SA-C)
Entity Type:Individual
Prefix:
First Name:DAMIAN
Middle Name:
Last Name:BELTRAN GARCES
Suffix:
Gender:M
Credentials:PA, SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5803 NW 151ST ST STE 202
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2473
Mailing Address - Country:US
Mailing Address - Phone:305-603-8844
Mailing Address - Fax:303-675-8452
Practice Address - Street 1:5803 NW 151ST ST STE 202
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2473
Practice Address - Country:US
Practice Address - Phone:305-603-8844
Practice Address - Fax:303-675-8452
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-14
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21-517246ZC0007X
PR000754-PA363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR000754-PAOtherDEPARTAMENTO DE SALUD