Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | ME123130 | FL |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | ME123130 | FL |
NPI | 1184885162 |
---|---|
Provider Name | Dr. Luis I Garcia |
First Address | Orlando, FL 32806-1215 |
Second Address | Orlando, FL 32806-1215 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2008 |
Last Update Date | 15/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
014680200 | (05) | FL |
ME123130 | MEDICAL LICENSE (01) | FL |