MEDICARE: MYRIAM P GARZON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	ME64290	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	23589	OTHER	FL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275529471
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MYRIAM P GARZON MD

Provider Business Mailing Address
First Line	:	PO BOX 893
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32790-0893
Country	:	US
Telephone Number	:
Fax Number	:	407-898-3997

Provider Business Practice Location Address
First Line	:	1517 E ROBINSON ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32801-2121
Country	:	US
Telephone Number	:	407-648-9500
Fax Number	:	407-898-3997

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2005
Last Update Date	:	11/29/2011

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