Provider Demographics
NPI:1295998813
Name:LUIS E GARCIA MD PA
Entity type:Organization
Organization Name:LUIS E GARCIA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:E
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-847-5511
Mailing Address - Street 1:5341 GRAND BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-4011
Mailing Address - Country:US
Mailing Address - Phone:727-847-5511
Mailing Address - Fax:727-842-4758
Practice Address - Street 1:5341 GRAND BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-4011
Practice Address - Country:US
Practice Address - Phone:727-847-5511
Practice Address - Fax:727-842-4758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-03
Last Update Date:2008-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAR919Medicare PIN