Provider Demographics
NPI:1821973439
Name:GARCIA MARTINEZ, INDIRA
Entity type:Individual
Prefix:
First Name:INDIRA
Middle Name:
Last Name:GARCIA MARTINEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11002 INDIAN OAKS DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625-4926
Mailing Address - Country:US
Mailing Address - Phone:813-993-3703
Mailing Address - Fax:
Practice Address - Street 1:6607 N DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-3985
Practice Address - Country:US
Practice Address - Phone:813-499-1500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN30755122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist