Provider Demographics
NPI:1871887976
Name:GARCIA, ELIZABETH ASHLEY (RN, LMT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ASHLEY
Last Name:GARCIA
Suffix:
Gender:F
Credentials:RN, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1973 RAILROAD VINE DR APT 302
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:FL
Mailing Address - Zip Code:33556-4485
Mailing Address - Country:US
Mailing Address - Phone:813-416-4837
Mailing Address - Fax:
Practice Address - Street 1:8322 N HABANA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-2819
Practice Address - Country:US
Practice Address - Phone:813-868-4357
Practice Address - Fax:813-466-7510
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-06
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA62074225700000X
FLRN9604590163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist