Provider Demographics
NPI:1518575430
Name:LYDIA GARIB GARCIA
Entity Type:Organization
Organization Name:LYDIA GARIB GARCIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:LIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARIB GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-860-1300
Mailing Address - Street 1:PO BOX 1107
Mailing Address - Street 2:
Mailing Address - City:FAJARDO
Mailing Address - State:PR
Mailing Address - Zip Code:00738-1107
Mailing Address - Country:US
Mailing Address - Phone:787-860-1300
Mailing Address - Fax:787-863-8300
Practice Address - Street 1:410 AVE GENERAL VALERO STE 408
Practice Address - Street 2:
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738-3992
Practice Address - Country:US
Practice Address - Phone:787-860-1300
Practice Address - Fax:787-863-8300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-16
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy