Healthcare Provider Details

I. General information

NPI: 1003707431
Provider Name (Legal Business Name): CRYSTAL GARCIA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2025
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36440 US HIGHWAY 19 N
PALM HARBOR FL
34684-1330
US

IV. Provider business mailing address

3251 N MCMULLEN BOOTH RD STE 303
CLEARWATER FL
33761-2022
US

V. Phone/Fax

Practice location:
  • Phone: 727-786-0696
  • Fax: 727-669-9742
Mailing address:
  • Phone: 727-725-6110
  • Fax: 727-669-9742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number681542
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: