Provider Demographics
NPI:1114100898
Name:GARCIA, OMAR (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:OMAR
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13449 CANOPY CREEK DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625-5915
Mailing Address - Country:US
Mailing Address - Phone:352-369-0104
Mailing Address - Fax:352-369-0107
Practice Address - Street 1:4104 W LINEBAUGH AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33624-5239
Practice Address - Country:US
Practice Address - Phone:813-333-2226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-17
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL238.000173246ZS0410X
IL036.1243892083X0100X
FLME 1279622083X0100X
DEC1-00116742083X0100X
OH35.1270942083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist