Provider Demographics
NPI:1740422096
Name:GARCIA, ANGELA SUZANNE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:SUZANNE
Last Name:GARCIA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:824 NE 17TH TER APT 5
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33304-4459
Mailing Address - Country:US
Mailing Address - Phone:954-873-7395
Mailing Address - Fax:
Practice Address - Street 1:824 NE 17TH TER APT 5
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33304-4459
Practice Address - Country:US
Practice Address - Phone:954-873-7395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-01
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS44306183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist