Provider Demographics
NPI:1063526549
Name:GARCIA GARCIA, JOSE M (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:M
Last Name:GARCIA GARCIA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:STREET A NUMBER 16
Mailing Address - Street 2:VILLA CAPARRA
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-0016
Mailing Address - Country:US
Mailing Address - Phone:787-750-0085
Mailing Address - Fax:787-762-4520
Practice Address - Street 1:STREE VIA LETICIA NUMBER 4AS1
Practice Address - Street 2:VILLA FONTANA
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985-0000
Practice Address - Country:US
Practice Address - Phone:787-750-0085
Practice Address - Fax:787-762-4520
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2017-12-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR7002174400000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRJOSE M GARCIAMedicare UPIN
PRJOSE M GARCIAMedicare ID - Type Unspecified99075