Provider Demographics
NPI:1427143890
Name:CARLOS A GARCIA-RIVERA, DOPA
Entity type:Organization
Organization Name:CARLOS A GARCIA-RIVERA, DOPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA-RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:305-229-9899
Mailing Address - Street 1:9240 SW 72ND ST STE 118
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3262
Mailing Address - Country:US
Mailing Address - Phone:305-229-9899
Mailing Address - Fax:786-431-2844
Practice Address - Street 1:9240 SW 72ND ST
Practice Address - Street 2:SUITE 118
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3261
Practice Address - Country:US
Practice Address - Phone:305-229-9899
Practice Address - Fax:786-431-2844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 85662084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE7374Medicare ID - Type Unspecified
FLH61081Medicare UPIN