Provider Demographics
NPI:1033673777
Name:GARCIA, ANA (OTR/L)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5016 RED BAY DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32829-8725
Mailing Address - Country:US
Mailing Address - Phone:407-223-2608
Mailing Address - Fax:
Practice Address - Street 1:2301 13TH ST
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769-4124
Practice Address - Country:US
Practice Address - Phone:407-913-1010
Practice Address - Fax:407-992-8697
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-28
Last Update Date:2024-02-08
Deactivation Date:2019-04-20
Deactivation Code:
Reactivation Date:2019-08-27
Provider Licenses
StateLicense IDTaxonomies
FL19745225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL104596100Medicaid