Provider Demographics
NPI:1841267069
Name:GARCIA, RONALD S (MD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:S
Last Name:GARCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:RONALD
Other - Middle Name:L
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:33100 CLEVELAND CLINIC BLVD
Mailing Address - Street 2:AVW4-1
Mailing Address - City:AVON
Mailing Address - State:OH
Mailing Address - Zip Code:44011
Mailing Address - Country:US
Mailing Address - Phone:440-695-4000
Mailing Address - Fax:440-695-4497
Practice Address - Street 1:33100 CLEVELAND CLINIC BLVD
Practice Address - Street 2:AVW4-1
Practice Address - City:AVON
Practice Address - State:OH
Practice Address - Zip Code:44011
Practice Address - Country:US
Practice Address - Phone:440-695-4000
Practice Address - Fax:440-695-4497
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2018-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35055671G207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
107870OtherKAISER
358100001OtherCARESOURCE BWC
000000031797OtherANTHEM
110131293OtherRR MEDICARE INDIVIDUAL
3610861OtherGROUP ASC MEDICARE
L55671OtherSUMMACARE APEX
0119204OtherGROUP MEDICAID
9273172OtherGROUP MEDICARE
D368301OtherGROUP IND DIAGNOSTICS MED
OH0722892Medicaid
CA4511OtherRR MEDICARE GROUP
10791811OtherCAQH
1780634279OtherGROUP NPI
2096461OtherAETNA
107870OtherKAISER
110131293OtherRR MEDICARE INDIVIDUAL
2096461OtherAETNA