Provider Demographics
NPI:1497721492
Name:GARCIA, LYNDON OGAN (MD)
Entity Type:Individual
Prefix:MR
First Name:LYNDON
Middle Name:OGAN
Last Name:GARCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8425 NORTHCLIFFE BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-1107
Mailing Address - Country:US
Mailing Address - Phone:352-683-5857
Mailing Address - Fax:352-683-5753
Practice Address - Street 1:8425 NORTHCLIFFE BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-1107
Practice Address - Country:US
Practice Address - Phone:352-683-5857
Practice Address - Fax:352-683-5753
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0071459207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL251863500Medicaid
FL32253WMedicare PIN
G38041Medicare UPIN