Provider Demographics
NPI:1508909003
Name:ERIC GARCIA MD PA
Entity Type:Organization
Organization Name:ERIC GARCIA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MAIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-217-3191
Mailing Address - Street 1:2293 CORAL HONEYSUCKLE BND APT 203
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:FL
Mailing Address - Zip Code:33556-4555
Mailing Address - Country:US
Mailing Address - Phone:813-217-3191
Mailing Address - Fax:813-885-7881
Practice Address - Street 1:5929 WEBB ROAD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615
Practice Address - Country:US
Practice Address - Phone:813-885-7873
Practice Address - Fax:813-885-7881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL32994Medicare ID - Type Unspecified
FLG50827Medicare UPIN