Provider Demographics
NPI:1871888131
Name:GARCIA, MANUEL G (MD)
Entity type:Individual
Prefix:
First Name:MANUEL
Middle Name:G
Last Name: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 1:1145 N ANNAPOLIS AVE
Mailing Address - Street 2:
Mailing Address - City:HERNANDO
Mailing Address - State:FL
Mailing Address - Zip Code:34442-3318
Mailing Address - Country:US
Mailing Address - Phone:352-527-0020
Mailing Address - Fax:
Practice Address - Street 1:295 WINDING WAY
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:IN
Practice Address - Zip Code:47006-7652
Practice Address - Country:US
Practice Address - Phone:812-934-0188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-15
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01022946A208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery