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Individual

MR. IVAN GARCIA I

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MA

Contact information

Practice address
8110 SW 2ND ST, MIAMI, FL 33144-2104
(786) 506-6668
(305) 819-2195
Mailing address
8110 SW 2ND ST, MIAMI, FL 33144-2104
(786) 506-6668
(305) 819-2195

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA 54762
FL
225700000X
Massage Therapist
MA54762
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MA 54762
MASSAGE THERAPIST
FL
Enumeration date
06/09/2010
Last updated
06/09/2010
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