Provider Demographics
NPI:1083250781
Name:GARCIA LUIS, MAITTE (APRN)
Entity type:Individual
Prefix:
First Name:MAITTE
Middle Name:
Last Name:GARCIA LUIS
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13701 SW 88TH ST STE 306
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-1309
Mailing Address - Country:US
Mailing Address - Phone:786-853-3218
Mailing Address - Fax:
Practice Address - Street 1:13701 SW 88TH ST STE 306
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1309
Practice Address - Country:US
Practice Address - Phone:786-853-3218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-18
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11005038363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care