Provider Demographics
NPI:1851691398
Name:GARCIA, HECTOR M JR (SAC)
Entity Type:Individual
Prefix:
First Name:HECTOR
Middle Name:M
Last Name:GARCIA
Suffix:JR
Gender:M
Credentials:SAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1861 SW 124TH WAY
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-2533
Mailing Address - Country:US
Mailing Address - Phone:305-804-6703
Mailing Address - Fax:
Practice Address - Street 1:1861 SW 124TH WAY
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-2533
Practice Address - Country:US
Practice Address - Phone:305-804-6703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-01
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10-244246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant