Provider Demographics
NPI:1699175554
Name:GARCIA, DEBORAH (ARNP)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10051 5TH ST N
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-2289
Mailing Address - Country:US
Mailing Address - Phone:727-828-2370
Mailing Address - Fax:
Practice Address - Street 1:1933 W LUMSDEN RD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-8819
Practice Address - Country:US
Practice Address - Phone:813-653-3111
Practice Address - Fax:813-653-1384
Is Sole Proprietor?:No
Enumeration Date:2014-08-28
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3310602363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL013389300Medicaid
FL013389300Medicaid