Provider Demographics
NPI:1134173123
Name:GARCIA, FLORENCIO B JR (MD)
Entity type:Individual
Prefix:DR
First Name:FLORENCIO
Middle Name:B
Last Name:GARCIA
Suffix:JR
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 1:1040 MAIN ST
Mailing Address - Street 2:PO BOX 1360
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-1816
Mailing Address - Country:US
Mailing Address - Phone:434-792-1433
Mailing Address - Fax:434-797-2807
Practice Address - Street 1:1040 MAIN ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-1816
Practice Address - Country:US
Practice Address - Phone:434-792-1433
Practice Address - Fax:434-797-2807
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101229995207RN0300X
NC200500190207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8906406Medicaid
VA171813OtherANTHEM
VA010124361Medicaid
8819039OtherCIGNA
3128394OtherMAMSI
NC2038612Medicare PIN
VA00W201D03Medicare PIN
VA010124361Medicaid
VAP00272171Medicare PIN