Provider Demographics
NPI:1558300376
Name:GARCIA, STACEY R (MS, DPT)
Entity Type:Individual
Prefix:DR
First Name:STACEY
Middle Name:R
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MS, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:486 CASTILLE DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34608-8493
Mailing Address - Country:US
Mailing Address - Phone:352-293-4398
Mailing Address - Fax:352-293-4398
Practice Address - Street 1:1202 MARINER BLVD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-5603
Practice Address - Country:US
Practice Address - Phone:352-515-0580
Practice Address - Fax:352-515-0603
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFL 20328225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK8827OtherMEDICARE GROUP PTAN
FLAB699YMedicare UPIN