Provider Demographics
NPI:1780040956
Name:ISAAC GARCIA, MARIA (TO)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:ISAAC GARCIA
Suffix:
Gender:F
Credentials:TO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URBANIZACION VILLAS DEL SOL CALLE 2 F-9
Mailing Address - Street 2:
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00976
Mailing Address - Country:UM
Mailing Address - Phone:787-410-4651
Mailing Address - Fax:
Practice Address - Street 1:URBANIZACION VILLAS DEL SOL CALLE 2 F-9
Practice Address - Street 2:
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00976
Practice Address - Country:UM
Practice Address - Phone:787-410-4651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-04
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR592174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist