MEDICARE: DR. STACEY R GARCIA MS, DPT

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	225100000X	Physical Therapist	FL 20328	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	K8827	OTHER	FL	MEDICARE GROUP PTAN

General Provider Information

NPI Number	:	1558300376
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STACEY R GARCIA MS, DPT

Provider Business Mailing Address
First Line	:	486 CASTILLE DR
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34608-8493
Country	:	US
Telephone Number	:	352-293-4398
Fax Number	:	352-293-4398

Provider Business Practice Location Address
First Line	:	1202 MARINER BLVD
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34609-5603
Country	:	US
Telephone Number	:	352-515-0580
Fax Number	:	352-515-0603

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

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	11/01/2016

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