Provider Demographics
NPI:1295045946
Name:GARCIA OPTOMETRIC CORP
Entity Type:Organization
Organization Name:GARCIA OPTOMETRIC CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST / PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JANE
Authorized Official - Middle Name:Z
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:941-721-3241
Mailing Address - Street 1:2609 WATERFORD WAY
Mailing Address - Street 2:UNIT B
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34221
Mailing Address - Country:US
Mailing Address - Phone:941-345-7576
Mailing Address - Fax:
Practice Address - Street 1:508 10TH STREET EAST
Practice Address - Street 2:
Practice Address - City:PALMETTO
Practice Address - State:FL
Practice Address - Zip Code:34221
Practice Address - Country:US
Practice Address - Phone:941-721-3241
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-15
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3647152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1356577043OtherPERSONAL NPI