Provider Demographics
NPI:1124479217
Name:GARCIA, IVONNE (ARNP)
Entity type:Individual
Prefix:
First Name:IVONNE
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7270 NW 12TH ST PH 6
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-1929
Mailing Address - Country:US
Mailing Address - Phone:305-591-1606
Mailing Address - Fax:305-591-1618
Practice Address - Street 1:7270 NW 12TH ST PH 6
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-1929
Practice Address - Country:US
Practice Address - Phone:305-591-1606
Practice Address - Fax:305-591-1618
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-29
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2514482363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily