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NPI Code Detail

MEDICARE: IVETTE GARCIA OTR

MEDICARE: IVETTE GARCIA OTR
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
1225X00000XOccupational TherapistOT 9897FL

General Provider Information

NPI Number : 1386867737
Entity Type Code : Individual
Provider Name (Legal Business Name) : IVETTE GARCIA OTR
Provider Business Mailing Address
First Line : 1102 WOODFLOWER WAY
Second Line :
City : CLERMONT
State : FL
Zip : 34714-7012
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 409 S 10TH ST
Second Line :
City : HAINES CITY
State : FL
Zip : 33844-5603
Country : US
Telephone Number : 863-422-8656
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2007
Last Update Date : 07/08/2007

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