Healthcare Provider Details

I. General information

NPI: 1013586759
Provider Name (Legal Business Name): ROSA AMELIA GARCIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2021
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 N CAUSEWAY
NEW SMYRNA BEACH FL
32169-5239
US

IV. Provider business mailing address

1671 N CLYDE MORRIS BLVD STE 100
DAYTONA BEACH FL
32117-5590
US

V. Phone/Fax

Practice location:
  • Phone: 386-410-4926
  • Fax: 386-402-4102
Mailing address:
  • Phone: 386-274-2977
  • Fax: 386-317-5164

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberME172901
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: