Provider Demographics
NPI:1023195898
Name:GARCIA, AIXA ZILA (MD)
Entity Type:Individual
Prefix:DR
First Name:AIXA
Middle Name:ZILA
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1875 FORTUNE RD
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-4428
Mailing Address - Country:US
Mailing Address - Phone:407-343-2000
Mailing Address - Fax:407-343-2002
Practice Address - Street 1:1875 FORTUNE RD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-4428
Practice Address - Country:US
Practice Address - Phone:407-343-2000
Practice Address - Fax:407-343-2002
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD27034207Q00000X
FLME68494207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL018108100Medicaid
OR165772Medicaid
OR165772Medicaid