Provider Demographics
NPI:1194903039
Name:GARCIA, NICOLE MARY (APRN - BC)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:MARY
Last Name:GARCIA
Suffix:
Gender:F
Credentials:APRN - BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1617 MOUNT VERNON ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-5508
Mailing Address - Country:US
Mailing Address - Phone:718-578-7508
Mailing Address - Fax:
Practice Address - Street 1:1617 MOUNT VERNON ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-5508
Practice Address - Country:US
Practice Address - Phone:718-578-7508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-01
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1194903039363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health