Provider Demographics
NPI:1609364371
Name:GARCIA, GLORIMAR (MSPT)
Entity type:Individual
Prefix:
First Name:GLORIMAR
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 12 BOX 10057
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956-9643
Mailing Address - Country:US
Mailing Address - Phone:787-365-2557
Mailing Address - Fax:
Practice Address - Street 1:28 CALLE T-1 #4
Practice Address - Street 2:URB. TURABO GARDENS 2
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-744-4343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-27
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1413225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist