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General NPI Number Information
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NPI Number | 1669481529
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Entity Type | Organization
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Legal Business Name | PEARL GARCIA STAFFING
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Dates
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Enumeration Date | 08/07/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2030 STONECROSS CIR
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City | ORLANDO
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State | FL
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Zip | 32828-7931
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Country | US
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Telephone | 407-929-7814
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Fax |
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Provider Business Mailing Address
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Address Line | 2030 STONE CROSS CIRCLE
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City | ORLANDO
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State | FL
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Zip | 32828-7931
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Country | US
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Telephone | 407-929-7814
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | PETER GARCIA
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Credential | MD
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Telephone | 407-929-7814
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME 074578
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License Number State | FL
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