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NPI Code Detail

MEDICARE: PABLO DAVID GARCIA ORTIZ

MEDICARE: PABLO DAVID GARCIA ORTIZ
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
1367500000XCertified Registered Nurse Anesthetist4704371761MI
2163W00000XRegistered Nurse4704371761MI

General Provider Information

NPI Number : 1902509094
Entity Type Code : Individual
Provider Name (Legal Business Name) : PABLO DAVID GARCIA ORTIZ
Provider Business Mailing Address
First Line : 1355 BOGUE ST
Second Line :
City : EAST LANSING
State : MI
Zip : 48824-6207
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1355 BOGUE ST
Second Line :
City : EAST LANSING
State : MI
Zip : 48824-6207
Country : US
Telephone Number : 812-629-4423
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2023
Last Update Date : 06/18/2025

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Directions to “ PABLO DAVID GARCIA ORTIZ ” Practice Location

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