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GARCIA MEDICAL CLINIC LLC NPI 1407971922


NPI Information

NPI: 1407971922
Provider Name: GARCIA MEDICAL CLINIC LLC
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization

CLIA Number: 10D2124259

Address:
411 E NELSON AVE
DEFUNIAK SPRINGS, FL
ZIP 32433
Phone: (850) 892-4791
Get Directions

GARCIA MEDICAL CLINIC LLC is a clinic center in Defuniak Springs, FL. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). GARCIA MEDICAL CLINIC LLC NPI is 1407971922. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

411 E NELSON AVE
DEFUNIAK SPRINGS, FL
ZIP 32433-444
Phone: (850) 892-4791
Fax: (850) 892-3868

The provider's authorized official is Ruben Ruiz Garcia .
The authorized official title is Physician/owner and has the following contact phone number (850) 892-4791.

The CLIA number assigned to this NPI record is 10D2124259 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/21/2007 and was last updated on 6/19/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208D00000XGeneral PracticeME59559FLORIDANo
2261Q00000XClinic/CenterME59559FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1E19933MEDICARE UPINFLORIDA
2108975MEDICARE OSCAR/CERTIFICATIONFLORIDA
3052715700MEDICAIDFLORIDA
411921OTHERFLORIDABLUE CROSS-BLUE SHIELD
5ME59559OTHERFLORIDACOMMERCIAL BILLING
6108975MEDICARE ID-TYPE UNSPECIFIEDFLORIDARURAL HEALTH CLINIC
7660200200MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.