Provider Demographics
NPI:1588646954
Name:GARCIA, GLORIA T (MD)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:T
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 E FLETCHER AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-4613
Mailing Address - Country:US
Mailing Address - Phone:813-615-7914
Mailing Address - Fax:813-615-8134
Practice Address - Street 1:3100 E FLETCHER AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-4613
Practice Address - Country:US
Practice Address - Phone:813-615-7914
Practice Address - Fax:813-615-8134
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME69307207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL28217OtherBCBS
FL379260900Medicaid
050042940OtherRAILROAD MEDICARE
FL379260900Medicaid
FL28217YMedicare ID - Type Unspecified
FL379260900Medicaid