Healthcare Provider Details

I. General information

NPI: 1386706463
Provider Name (Legal Business Name): MARIA LILIANA GARCIA M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CONDOMINIO ASTRALIS 907 CLLE. DIAZ WAY ISLA VERDE
CAROLINA PUERTO RICO
00979
UM

IV. Provider business mailing address

CONDOMINIO ASTRALIS 907 CLLE. DIAZ WAY ISLA VERDE
CAROLINA PUERTO RICO
00979
UM

V. Phone/Fax

Practice location:
  • Phone: 787-772-6966
  • Fax:
Mailing address:
  • Phone: 787-772-6966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number12649
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: