Healthcare Provider Details

I. General information

NPI: 1417162660
Provider Name (Legal Business Name): MARIA TERESA GARCIA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 05/21/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE DEGETAU ESQ MUNOZ RIVERA 45
JUANA DIAZ PR
00795
US

IV. Provider business mailing address

CALLE DEGETAU ESQ MUNOZ RIVERA 45
JUANA DIAZ PR
00795
US

V. Phone/Fax

Practice location:
  • Phone: 787-837-3530
  • Fax:
Mailing address:
  • Phone: 787-837-3530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number7096
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: