Provider Demographics
NPI:1992865679
Name:GARCIA, JOVEN T (MD)
Entity Type:Individual
Prefix:
First Name:JOVEN
Middle Name:T
Last Name:GARCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6080 BABCOCK ST SE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32909-3921
Mailing Address - Country:US
Mailing Address - Phone:321-409-3073
Mailing Address - Fax:321-409-3075
Practice Address - Street 1:6080 BABCOCK ST SE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32909-3921
Practice Address - Country:US
Practice Address - Phone:321-409-3073
Practice Address - Fax:321-409-3075
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME91361207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU3485ZMedicare ID - Type UnspecifiedMEDICARE
FLI18772Medicare UPIN