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General NPI Number Information
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NPI Number | 1740493055
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Entity Type | Individual
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Provider Name | MARIA LOURDES GARCIA GONZALEZ M.D., PHD
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Gender | Female
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 10/26/2021
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Provider Practice Location Address
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Address Line | 6315 N CENTER DR STE 230
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City | NORFOLK
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State | VA
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Zip | 23502-4006
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Country | US
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Telephone | 757-461-7974
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Fax |
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Provider Business Mailing Address
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Address Line | 1464 MOUNT PLEASANT RD UNIT 16 SUITE 309
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City | CHESAPEAKE
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State | VA
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Zip | 23322-4043
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Country | US
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Telephone | 757-880-8969
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Fax | 757-428-0514
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 0101241378
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License Number State | VA
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