Provider Demographics
NPI:1023373388
Name:GARCIA, IGNACIO JOSE (DC)
Entity Type:Individual
Prefix:DR
First Name:IGNACIO
Middle Name:JOSE
Last Name:GARCIA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 LANGFORD DR
Mailing Address - Street 2:
Mailing Address - City:CHULUOTA
Mailing Address - State:FL
Mailing Address - Zip Code:32766-9666
Mailing Address - Country:US
Mailing Address - Phone:407-454-1368
Mailing Address - Fax:
Practice Address - Street 1:4932 WEST S.R. 46
Practice Address - Street 2:1006
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771
Practice Address - Country:US
Practice Address - Phone:407-979-4908
Practice Address - Fax:407-979-4967
Is Sole Proprietor?:No
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10694111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor