MEDICARE: DR. ELIZABETH AQUINO GARCIA-JANIS MD

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	2084P0804X	Child & Adolescent Psychiatry Physician	4301100092	MI
2	2084P0804X	Child & Adolescent Psychiatry Physician	DR.0052141	CO
3	2084P0804X	Child & Adolescent Psychiatry Physician	01033027A	IN
4	2084P0804X	Child & Adolescent Psychiatry Physician	21686	KY
5	2084P0804X	Child & Adolescent Psychiatry Physician	9235	SD
6	2084P0804X	Child & Adolescent Psychiatry Physician	MD-17894	HI

General Provider Information

NPI Number	:	1417987231
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIZABETH AQUINO GARCIA-JANIS MD

Provider Business Mailing Address
First Line	:	23402 MINERAL LN
Second Line	:
City	:	HILL CITY
State	:	SD
Zip	:	57745-6617
Country	:	US
Telephone Number	:	605-441-7803
Fax Number	:

Provider Business Practice Location Address
First Line	:	23402 MINERAL LN
Second Line	:
City	:	HILL CITY
State	:	SD
Zip	:	57745-6617
Country	:	US
Telephone Number	:	605-441-7803
Fax Number	:

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

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	12/02/2021

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