Provider Demographics
NPI:1083352637
Name:GARNICA, ELSA F (APRN)
Entity Type:Individual
Prefix:
First Name:ELSA
Middle Name:F
Last Name:GARNICA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3440 CLINGMAN ST
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32738-1288
Mailing Address - Country:US
Mailing Address - Phone:386-848-4288
Mailing Address - Fax:
Practice Address - Street 1:1133 SAXON BLVD STE 200
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-8425
Practice Address - Country:US
Practice Address - Phone:386-228-0590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8600207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine