Provider Demographics
NPI:1801068135
Name:GARCIA, RAFAEL A (MD)
Entity type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:A
Last Name:GARCIA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2271 BIRDWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-5339
Mailing Address - Country:US
Mailing Address - Phone:786-972-6710
Mailing Address - Fax:904-639-5021
Practice Address - Street 1:151 COLLEGE DR STE 3
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32065-7684
Practice Address - Country:US
Practice Address - Phone:904-214-6719
Practice Address - Fax:904-639-5021
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-27
Last Update Date:2021-05-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME105065207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009422900Medicaid