Doctor Name: | DR. LUIS GARCIA RIVERA |
NPI Number: | 1164539870 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 13253 |
Business Practice Address: | 5425 S Florida Ave Lakeland, FL - 33813 |
Business Phone Number: | 8636443585 |
Business Fax Number: | 8636443171 |
Mailing Address: | 1955 Wind Meadows Dr, BARTOW |
State: | FL |
Postal Code: | 338302937 |
Phone Number: | 7872158576 |
Fax Number: | |
NPI Enumeration Date: | 08/25/2006 |
NPI Last Update Date: | 03/04/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 13253 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |