Provider Demographics
NPI:1942262704
Name:GARCIA, LILLIAM I (MD)
Entity Type:Individual
Prefix:DR
First Name:LILLIAM
Middle Name:I
Last Name:GARCIA
Suffix:
Gender:F
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:ALTURAS DE SAN JOSE #00-25 CALLE 21
Mailing Address - Street 2:
Mailing Address - City:SABANA GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00637-2632
Mailing Address - Country:US
Mailing Address - Phone:787-873-0841
Mailing Address - Fax:
Practice Address - Street 1:ALTURAS DE SAN JOSE #00-25 CALLE 21
Practice Address - Street 2:
Practice Address - City:SABANA GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00637-2632
Practice Address - Country:US
Practice Address - Phone:787-873-0841
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13569174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR13569OtherMEDICAL LICENSE