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General NPI Number Information
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NPI Number | 1447387295
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Entity Type | Organization
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Legal Business Name | GERARDO E GARCIA MD LLC
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 10/22/2007
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Provider Practice Location Address
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Address Line | 4054 BEAVER LN SUTIE 1
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-9296
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Country | US
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Telephone | 941-613-6850
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Fax | 941-613-6851
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Provider Business Mailing Address
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Address Line | 4054 BEAVER LN SUTIE 1
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-9296
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Country | US
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Telephone | 941-613-6850
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Fax | 941-613-6851
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. GERARDO E GARCIA
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Credential | MD
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Telephone | 941-613-6850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME91360
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License Number State | FL
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