Provider Demographics
NPI:1386785145
Name:GARCIA, JUAN CARLOS (DC)
Entity type:Individual
Prefix:DR
First Name:JUAN
Middle Name:CARLOS
Last Name:GARCIA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 MIRACLE MILE
Mailing Address - Street 2:SUIT # 304
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134
Mailing Address - Country:US
Mailing Address - Phone:954-647-1213
Mailing Address - Fax:786-999-0153
Practice Address - Street 1:401 CORAL WAY STE 304
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-4926
Practice Address - Country:US
Practice Address - Phone:786-899-0214
Practice Address - Fax:786-999-0153
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9235111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCJHTMedicare ID - Type Unspecified
GAV06235Medicare UPIN