Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | ME0037831 | FL |
NPI | 1003816463 |
---|---|
Provider Name | Luis R Garcia-Mayol |
First Address | Coral Gables, FL 33134-2049 |
Second Address | Coral Gables, FL 33134-2049 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2005 |
Last Update Date | 21/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
065186900 | (05) | FL |
D63554 | (02) | FL |