Provider Demographics
NPI:1194774596
Name:GARCIA, ERIC A (MD)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:A
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 1:10987 SHELDON RD STE 200
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-4702
Mailing Address - Country:US
Mailing Address - Phone:813-467-4800
Mailing Address - Fax:813-467-4252
Practice Address - Street 1:10987 SHELDON RD STE 200
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626-4702
Practice Address - Country:US
Practice Address - Phone:813-467-4800
Practice Address - Fax:813-467-4252
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME72538207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL251515600Medicaid
FL251515600Medicaid
32994Medicare ID - Type Unspecified