Provider Demographics
NPI:1750359600
Name:GARCIA, MANUEL ENRIQUE (MD)
Entity type:Individual
Prefix:
First Name:MANUEL
Middle Name:ENRIQUE
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 1:7500 SW 8TH ST
Mailing Address - Street 2:SUIE 202
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-4400
Mailing Address - Country:US
Mailing Address - Phone:305-261-7800
Mailing Address - Fax:305-261-2728
Practice Address - Street 1:7500 SW 8TH ST
Practice Address - Street 2:SUIE 202
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4400
Practice Address - Country:US
Practice Address - Phone:305-261-7800
Practice Address - Fax:305-261-2728
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00446882084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
D77101Medicare UPIN
FL96685YMedicare ID - Type Unspecified