MEDICARE: DR. OMAR GARCIA M.D, M.P.H

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246ZS0410X	Surgical Technologist	238.000173	IL
2	2083X0100X	Occupational Medicine Physician	036.124389	IL
3	2083X0100X	Occupational Medicine Physician	ME 127962	FL
4	2083X0100X	Occupational Medicine Physician	C1-0011674	DE
5	2083X0100X	Occupational Medicine Physician	35.127094	OH

General Provider Information

NPI Number	:	1114100898
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OMAR GARCIA M.D, M.P.H

Provider Business Mailing Address
First Line	:	13449 CANOPY CREEK DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33625-5915
Country	:	US
Telephone Number	:	352-369-0104
Fax Number	:	352-369-0107

Provider Business Practice Location Address
First Line	:	4104 W LINEBAUGH AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33624-5239
Country	:	US
Telephone Number	:	813-333-2226
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/17/2007
Last Update Date	:	04/15/2019

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