Provider Demographics
NPI:1053908699
Name:GARCIA, RUSLAN (PHARMD)
Entity type:Individual
Prefix:
First Name:RUSLAN
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9813 SW 221ST ST
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33190-1404
Mailing Address - Country:US
Mailing Address - Phone:786-218-4809
Mailing Address - Fax:
Practice Address - Street 1:1160 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-2918
Practice Address - Country:US
Practice Address - Phone:305-663-8697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS59832183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist