Provider Demographics
NPI:1396269189
Name:GARCES, LUIS CARLOS (RD/LDN)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:CARLOS
Last Name:GARCES
Suffix:
Gender:M
Credentials:RD/LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7663 SW 147TH TER
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33158-1675
Mailing Address - Country:US
Mailing Address - Phone:305-905-5894
Mailing Address - Fax:
Practice Address - Street 1:7663 SW 147TH TER
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33158-1675
Practice Address - Country:US
Practice Address - Phone:305-905-5894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-02
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND6188133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered