Healthcare Provider Details

I. General information

NPI: 1518020460
Provider Name (Legal Business Name): LINDA LOU GARCIA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 WEST 6TH STREET CENTER FOR WOMEN AND CHILDREN
JACKSONVILLE FL
32206
US

IV. Provider business mailing address

910 NORTH JEFFERSON STREET
JACKSONVILLE FL
32209-6810
US

V. Phone/Fax

Practice location:
  • Phone: 904-665-2721
  • Fax:
Mailing address:
  • Phone: 904-665-2721
  • Fax: 904-632-5330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN9246751
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: