Provider Demographics
NPI:1447286679
Name:PITA GARCIA, IGNACIO L (MD)
Entity type:Individual
Prefix:
First Name:IGNACIO
Middle Name:L
Last Name:PITA 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:LA VILLA DE TORRIMAR
Mailing Address - Street 2:CALLE REY FRANSICO 332
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-751-2509
Mailing Address - Fax:787-781-5307
Practice Address - Street 1:101 AVE SAN PACTRICIO
Practice Address - Street 2:MARAMAR PLAZA SUITE 1270
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968
Practice Address - Country:US
Practice Address - Phone:787-751-2509
Practice Address - Fax:787-781-5307
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR144342084N0400X, 2084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology