Provider Demographics
NPI:1194050260
Name:GARCIA, SANTO IGNACIO (MOTR/L)
Entity type:Individual
Prefix:
First Name:SANTO
Middle Name:IGNACIO
Last Name:GARCIA
Suffix:
Gender:M
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 61105
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33906-1105
Mailing Address - Country:US
Mailing Address - Phone:239-565-8300
Mailing Address - Fax:239-829-4709
Practice Address - Street 1:9400 GLADIOLUS DR
Practice Address - Street 2:SUITE #60
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-6699
Practice Address - Country:US
Practice Address - Phone:239-565-8300
Practice Address - Fax:239-829-8300
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-07
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11998225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist