Provider Demographics
NPI:1881601417
Name:GARCES, CARLOS ALBERTO (LMT)
Entity type:Individual
Prefix:MR
First Name:CARLOS
Middle Name:ALBERTO
Last Name:GARCES
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12290 SW 186TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-3160
Mailing Address - Country:US
Mailing Address - Phone:305-251-4463
Mailing Address - Fax:305-256-1182
Practice Address - Street 1:12290 SW 186TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-3160
Practice Address - Country:US
Practice Address - Phone:305-251-4463
Practice Address - Fax:305-256-1182
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA34058225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC2529OtherBC&BS