Provider Demographics
NPI:1366653271
Name:ROBERTO GARCIA MD PA
Entity Type:Organization
Organization Name:ROBERTO GARCIA MD PA
Other - Org Name:THE ALLERGI GROUP
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-926-4058
Mailing Address - Street 1:PO BOX 262186
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33685-2186
Mailing Address - Country:US
Mailing Address - Phone:813-926-4058
Mailing Address - Fax:813-926-9872
Practice Address - Street 1:10940 SHELDON RD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626-4701
Practice Address - Country:US
Practice Address - Phone:813-926-4058
Practice Address - Fax:813-926-9872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME46917207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL263128800Medicaid
FLK2886Medicare ID - Type UnspecifiedGROUP
FLD19856Medicare UPIN