Provider Demographics
NPI:1962955948
Name:GARCIA DELGADO, CONNIE M (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CONNIE
Middle Name:M
Last Name:GARCIA DELGADO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1337 HAMPSTEAD TER
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-5118
Mailing Address - Country:US
Mailing Address - Phone:407-803-3515
Mailing Address - Fax:407-926-0582
Practice Address - Street 1:1337 HAMPSTEAD TER
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-5118
Practice Address - Country:US
Practice Address - Phone:407-803-3515
Practice Address - Fax:407-926-0582
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-26
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS41039183500000X
FLPU59941835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835G0303XPharmacy Service ProvidersPharmacistGeriatric