Healthcare Provider Details

I. General information

NPI: 1235689787
Provider Name (Legal Business Name): MERCY FRANCISCO GARCIA O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MERCY JUAN FRANCISCO O.D.

II. Dates (important events)

Enumeration Date: 10/08/2016
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21275 OLEAN BLVD
PORT CHARLOTTE FL
33952-6704
US

IV. Provider business mailing address

PO BOX 11407
BIRMINGHAM AL
35246-8575
US

V. Phone/Fax

Practice location:
  • Phone: 941-625-1325
  • Fax: 941-625-6482
Mailing address:
  • Phone: 864-359-1308
  • Fax: 239-496-3939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number9408TG
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number6952
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: