Provider Demographics
NPI:1376694042
Name:GARCIA, ANA CARLA
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:CARLA
Last Name:GARCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 CHESHIRE LN N
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55446-3706
Mailing Address - Country:US
Mailing Address - Phone:763-268-4169
Mailing Address - Fax:763-268-4240
Practice Address - Street 1:4058 FIESTA PLZ
Practice Address - Street 2:SUITE 107
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6834
Practice Address - Country:US
Practice Address - Phone:813-875-6697
Practice Address - Fax:813-874-7214
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS4005237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist