Provider Demographics
NPI:1982895298
Name:GARCIA-CARDONA, MARIA E (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:E
Last Name:GARCIA-CARDONA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:E
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1801 N BELCHER RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33765-1452
Mailing Address - Country:US
Mailing Address - Phone:727-669-3676
Mailing Address - Fax:727-669-3676
Practice Address - Street 1:26344 US HIGHWAY 19 N
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-4505
Practice Address - Country:US
Practice Address - Phone:727-669-3676
Practice Address - Fax:727-669-3669
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16907207N00000X
FLME11159207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL006447500Medicaid
FLFZ649ZMedicare PIN
FL006447500Medicaid