Provider Demographics
NPI:1699738104
Name:ELIZA GARCIA, MIGUEL A (5396)
Entity type:Individual
Prefix:DR
First Name:MIGUEL
Middle Name:A
Last Name:ELIZA GARCIA
Suffix:
Gender:M
Credentials:5396
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:14 CARR 833
Mailing Address - Street 2:CIMA DE TORRIMAR 1404
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-7401
Mailing Address - Country:US
Mailing Address - Phone:787-767-0102
Mailing Address - Fax:787-767-1899
Practice Address - Street 1:AVE DE DIEGO
Practice Address - Street 2:371
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-767-0102
Practice Address - Fax:787-767-1899
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-07
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR05396207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0027276Medicare PIN
PR501794OtherACCA
PR27276OtherTRIPLE S
PR27276OtherMEDICARE OPTIMO