Provider Demographics
NPI:1922000314
Name:GARCIA, HERNANDO (MD)
Entity Type:Individual
Prefix:DR
First Name:HERNANDO
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:HERNANDO
Other - Middle Name:
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:4302 ALTON RD
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2891
Mailing Address - Country:US
Mailing Address - Phone:305-674-2055
Mailing Address - Fax:305-675-2075
Practice Address - Street 1:4302 ALTON RD
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2891
Practice Address - Country:US
Practice Address - Phone:305-674-2055
Practice Address - Fax:305-674-2075
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN1642207RP1001X
FLME0063669207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL372858700Medicaid
TX198425401Medicaid
FLF61417Medicare UPIN
TX8L3921Medicare UPIN
FL18852Medicare ID - Type Unspecified
TX198425401Medicaid