Provider Demographics
NPI:1447977962
Name:GARCIA, MIRANIS (ARNP)
Entity type:Individual
Prefix:
First Name:MIRANIS
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27104 S DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-7317
Mailing Address - Country:US
Mailing Address - Phone:305-247-0018
Mailing Address - Fax:305-247-0078
Practice Address - Street 1:27104 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-7317
Practice Address - Country:US
Practice Address - Phone:305-247-0018
Practice Address - Fax:305-247-0078
Is Sole Proprietor?:No
Enumeration Date:2022-10-25
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF01220194363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003619700OtherFAMILY PRACTICE