Provider Demographics
NPI:1861685034
Name:BECKER, GARTH G (MD)
Entity Type:Individual
Prefix:DR
First Name:GARTH
Middle Name:G
Last Name:BECKER
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 1:8200 WORLD CENTER DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32821-5400
Mailing Address - Country:US
Mailing Address - Phone:407-465-1110
Mailing Address - Fax:407-465-1222
Practice Address - Street 1:8200 WORLD CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32821-5400
Practice Address - Country:US
Practice Address - Phone:407-465-1110
Practice Address - Fax:407-465-1222
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101241950207R00000X, 208M00000X
FLME100498207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00730179OtherRR MEDICARE
FL000695200Medicaid
FLBT844ZMedicare PIN