Provider Demographics
NPI:1669478301
Name:GARCIA, WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
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:PRADERA DEL RIO
Mailing Address - Street 2:3197 RIO GUAYABO
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953-9120
Mailing Address - Country:US
Mailing Address - Phone:787-667-9943
Mailing Address - Fax:787-799-0405
Practice Address - Street 1:CARR. 831 KM. 4.7
Practice Address - Street 2:BO. MINILLAS
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00960
Practice Address - Country:US
Practice Address - Phone:787-995-0884
Practice Address - Fax:787-995-0884
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-27
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR14583208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH81805Medicare UPIN
PR0084758Medicare ID - Type Unspecified