Healthcare Provider Details

I. General information

NPI: 1316712755
Provider Name (Legal Business Name): EUGENIA CAROLINA GARCIA BELISARIO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2023
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N SEMORAN BLVD STE 102
ORLANDO FL
32807-3381
US

IV. Provider business mailing address

2698 CHANTILLY AVE
KISSIMMEE FL
34741-7988
US

V. Phone/Fax

Practice location:
  • Phone: 407-277-6272
  • Fax:
Mailing address:
  • Phone: 781-666-1433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN31239
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDL101259
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: