Garcia Institute Ponte Vedra LLC

Primary specialty

Plastic Surgery Within the Head and Neck (Plastic Surgery) PhysicianTaxonomy code 2082S0099X

License

ME86699 Issued in FL

Legal business name

GARCIA INSTITUTE PONTE VEDRA LLC

Practice address

190 A1A N # 1
Ponte Vedra Beach, FL 32082-1773

Phone

(904) 686-8020

Fax

(904) 834-2592

NPI assigned

Jul 30, 2015

Organization subpart

No

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

Authorized official

Name

Roberto Garcia, M.D.

Title

Owner

Phone

(904) 686-8020

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1438214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473897600000",
    "number": "1659756740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 A1A N # 1",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320821773",
            "telephone_number": "904-686-8020",
            "fax_number": "904-834-2592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 A1A N # 1",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320821773",
            "telephone_number": "904-686-8020",
            "fax_number": "904-834-2592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARCIA INSTITUTE PONTE VEDRA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-30",
        "last_updated": "2016-09-15",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "ROBERTO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-686-8020",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2082S0099X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "FL",
            "license": "ME86699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "U6245Y",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chelsey Gallegos
• Kristen Galloway
• Susan Gambardella
• Gregory Lee Garamoni, PHD
• Garcia Aesthetic & Wellness Center Inc
• Roberto Eloy Garcia, MD
• GBC Mental Health & Wellness LLC
• Cynthia Geddes, LCSW
• Genetics and Metabolism LLC
• Sarah J Georges, DMD

• Plastic Surgery Physician in Ponte Vedra Beach, FL
• Providers in Ponte Vedra Beach, FL by specialty
• Plastic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.