Nicolas D Garzon Mancera, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1611 NW 12TH Ave FL 33136
Miami, FL 33136-1005

Phone

(305) 355-1122

NPI assigned

Apr 11, 2024

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in RI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1712793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1659125284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 CASS AVE",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028954731",
            "telephone_number": "401-769-4100",
            "fax_number": "401-769-5488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE FL 33136",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361005",
            "telephone_number": "305-355-1122"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 Cass Ave",
            "address_purpose": "LOCATION",
            "city": "Woonsocket",
            "state": "RI",
            "postal_code": "028954731",
            "country_code": "US",
            "telephone_number": "401-769-4100",
            "fax_number": "401-769-5488",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARZON MANCERA",
        "first_name": "NICOLAS",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-11",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary S Ziegler MD PA
• Arnulfo Garza Reyes, MD
• Annabelle Perla Garza
• Erick Astolfo Garza, MD
• Erik Daniel Garza, MD
• Claudia Liliana Garzon Rodriguez, RBT
• Anamaria Garzon, MS, CCC-SLP
• Catalina Garzon
• Diane Garzon, BA
• Diego Alejandro Garzon, RD

• Student in an Organized Health Care Education/Training Program in Miami, FL
• Providers in Miami, FL by specialty
• Student in an Organized Health Care Education/Training Program in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.