Provider Demographics
NPI:1487652327
Name:GARCIA, REBECCA B (ARNP)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:B
Last Name:GARCIA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34041 US HIGHWAY 19 N
Mailing Address - Street 2:SUITE C
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-2648
Mailing Address - Country:US
Mailing Address - Phone:727-784-3366
Mailing Address - Fax:727-784-3527
Practice Address - Street 1:34041 US HIGHWAY 19 N
Practice Address - Street 2:SUITE C
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-2648
Practice Address - Country:US
Practice Address - Phone:727-784-3366
Practice Address - Fax:727-784-3527
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9164627363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLQ15205Medicare UPIN
FLU2263ZMedicare ID - Type Unspecified