Provider Demographics
NPI:1932486248
Name:JAIME GARCIA, M.D., P.A.
Entity Type:Organization
Organization Name:JAIME GARCIA, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GONZALO
Authorized Official - Middle Name:
Authorized Official - Last Name:ESTEVEZ
Authorized Official - Suffix:V
Authorized Official - Credentials:MBA
Authorized Official - Phone:305-827-2489
Mailing Address - Street 1:935 W 49TH ST
Mailing Address - Street 2:SUITE 107
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3436
Mailing Address - Country:US
Mailing Address - Phone:305-827-2268
Mailing Address - Fax:
Practice Address - Street 1:935 W 49TH ST
Practice Address - Street 2:SUITE 107
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3436
Practice Address - Country:US
Practice Address - Phone:305-827-2268
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-15
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0067819173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL377108300Medicaid