Provider Demographics
NPI:1073791414
Name:GARCIA, ANTONIO (ATO)
Entity Type:Individual
Prefix:MR
First Name:ANTONIO
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:ATO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE 4 BELTRAN 97
Mailing Address - Street 2:
Mailing Address - City:FAJARDO
Mailing Address - State:PR
Mailing Address - Zip Code:00738-9725
Mailing Address - Country:US
Mailing Address - Phone:787-767-7676
Mailing Address - Fax:787-764-9904
Practice Address - Street 1:CALLE 4 #97 PARCELAS BELTRAN
Practice Address - Street 2:
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738-9725
Practice Address - Country:US
Practice Address - Phone:787-767-7676
Practice Address - Fax:787-764-9904
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR399224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant