Healthcare Provider Details

I. General information

NPI: 1952375420
Provider Name (Legal Business Name): FLORENCE C. GARROVILLAS,M.D., INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 01/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 S FARMERSVILLE BLVD SUITE B
FARMERSVILLE CA
93223-1845
US

IV. Provider business mailing address

160 S FARMERSVILLE BLVD SUITE B
FARMERSVILLE CA
93223-1845
US

V. Phone/Fax

Practice location:
  • Phone: 559-747-7000
  • Fax: 559-747-7011
Mailing address:
  • Phone: 559-747-7000
  • Fax: 559-747-7011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA77326
License Number StateCA

VIII. Authorized Official

Name: DR. FLORENCE CALLANTA GARROVILLAS
Title or Position: PRESIDENT/CEO
Credential: M.D.
Phone: 559-747-7000