Basic Information
| Provider Information | |||||||||
| NPI: | 1679750335 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GARCIA | ||||||||
| FirstName: | ALI | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13020 SW 51ST ST | ||||||||
| Address2: | |||||||||
| City: | MIRAMAR | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330275534 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7862104409 | ||||||||
| FaxNumber: | 9544325060 | ||||||||
| Practice Location | |||||||||
| Address1: | 13020 SW 51ST ST | ||||||||
| Address2: | |||||||||
| City: | MIRAMAR | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330275534 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7862104409 | ||||||||
| FaxNumber: | 9544325060 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/24/2008 | ||||||||
| LastUpdateDate: | 09/19/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | ME0101783 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | ME0101783 | FL | N | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 0001521-00 | 05 | FL | MEDICAID | AL602 | 01 | FL | MEDICARE | OTHER |