Provider Demographics
NPI:1699773317
Name:GARCIA, MARIA SYLVIA (PT)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:SYLVIA
Last Name:GARCIA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2285 THUMB BUTTE RD
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305-7551
Mailing Address - Country:US
Mailing Address - Phone:928-443-5223
Mailing Address - Fax:
Practice Address - Street 1:1526 IDYLWILD DR
Practice Address - Street 2:SUITE A
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-2237
Practice Address - Country:US
Practice Address - Phone:928-442-1234
Practice Address - Fax:928-442-1351
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1133174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ105417Medicare PIN