Provider Demographics
NPI:1154571560
Name:GARCIA MORELL, JUAN CARLOS (MD)
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:CARLOS
Last Name:GARCIA MORELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 PINELLAS ST STE 400
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-3356
Mailing Address - Country:US
Mailing Address - Phone:727-445-1911
Mailing Address - Fax:727-445-1986
Practice Address - Street 1:455 PINELLAS ST STE 400
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3356
Practice Address - Country:US
Practice Address - Phone:727-445-1911
Practice Address - Fax:727-445-1986
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-22
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME127898207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Single Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017723900Medicaid
FL017723900Medicaid