Organization
GARCIA INSTITUTE PONTE VEDRA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERTO GARCIA M.D. (OWNER)
(904) 686-8020
Entity
Organization
Contact information
Practice address
190 A1A N # 1, PONTE VEDRA BEACH, FL 32082-1773
(904) 686-8020
(904) 834-2592
Mailing address
190 A1A N # 1, PONTE VEDRA BEACH, FL 32082-1773
(904) 686-8020
(904) 834-2592
Taxonomy
Speciality
Code
Description
License number
State
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
Primary
ME86699
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
U6245Y
MEDICARE PTAN
—
Enumeration date
07/30/2015
Last updated
09/15/2016
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