Organization
GARCIA MEDICAL CLINIC LLC
Active
Organization
GARCIA MEDICAL CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUBEN RUIZ GARCIA JR. M.D. (PHYSICIAN/OWNER)
(850) 892-4791
Entity
Organization
Contact information
Practice address
411 E NELSON AVE, DEFUNIAK SPRINGS, FL 32433-7444
(850) 892-4791
(850) 892-3868
Mailing address
411 E NELSON AVE, DEFUNIAK SPRINGS, FL 32433-7444
(850) 892-4791
(850) 892-3868
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
ME59559
FL
261Q00000X
Clinic/Center
Primary
ME59559
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
052715700
—
FL
01
—
11921
BLUE CROSS-BLUE SHIELD
FL
05
—
660200200
—
FL
01
—
ME59559
COMMERCIAL BILLING
FL
Enumeration date
03/21/2007
Last updated
06/19/2017
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