Provider Demographics
NPI:1952419640
Name:GARCIA, PABLO JR (MD)
Entity type:Individual
Prefix:DR
First Name:PABLO
Middle Name:
Last Name:GARCIA
Suffix:JR
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 1:1425 HAND AVE STE F
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-1136
Mailing Address - Country:US
Mailing Address - Phone:386-317-8500
Mailing Address - Fax:386-317-8501
Practice Address - Street 1:1425 HAND AVE STE F
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-1136
Practice Address - Country:US
Practice Address - Phone:386-317-8500
Practice Address - Fax:386-317-8501
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME55445207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL11615OtherBLUE CROSS BLUE SHIELD
FL371266401Medicaid
FL593218216OtherHUMANA
FL593218216OtherTRICARE
FL595275OtherAETNA
FL371266401Medicaid
FL593218216OtherTRICARE
FL595275OtherAETNA