Provider Demographics
NPI:1104804293
Name:GARCIA, EDDIE ALONZO (MD)
Entity type:Individual
Prefix:DR
First Name:EDDIE
Middle Name:ALONZO
Last Name:GARCIA
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 1:4409 SUN N LAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33872-2170
Mailing Address - Country:US
Mailing Address - Phone:863-402-3480
Mailing Address - Fax:863-402-3483
Practice Address - Street 1:4409 SUN N LAKE BLVD
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33872-2170
Practice Address - Country:US
Practice Address - Phone:863-402-3480
Practice Address - Fax:863-402-3483
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6228207X00000X, 207XX0005X
FLME147875207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8G1481OtherBCBS
TX165438601Medicaid
E16348Medicare UPIN
TX8B7899Medicare ID - Type Unspecified
TXAETNAOther4342622