Healthcare Provider Details

I. General information

NPI: 1083354591
Provider Name (Legal Business Name): ITIKA GARG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2022
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6333 N FEDERAL HWY STE 300
FORT LAUDERDALE FL
33308-1909
US

IV. Provider business mailing address

6333 N FEDERAL HWY STE 300 RETINA GROUP OF FLORIDA
FORT LAUDERDALE FL
33308-1909
US

V. Phone/Fax

Practice location:
  • Phone: 954-776-6880
  • Fax: 954-776-6895
Mailing address:
  • Phone: 954-776-6880
  • Fax: 954-776-6895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License NumberME179245
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: