Provider Demographics
NPI:1518992288
Name:GARCIA, ANNITA E (PA-C)
Entity Type:Individual
Prefix:PROF
First Name:ANNITA
Middle Name:E
Last Name:GARCIA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:339 CYPRESS PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34759-3315
Mailing Address - Country:US
Mailing Address - Phone:407-343-3333
Mailing Address - Fax:407-343-8888
Practice Address - Street 1:339 CYPRESS PKWY STE 100
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34759-3315
Practice Address - Country:US
Practice Address - Phone:407-343-3333
Practice Address - Fax:407-343-8888
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9102615363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
U2549YMedicare PIN
FLQ21325Medicare UPIN