Provider Demographics
NPI:1053382556
Name:GARCIA, ODETTE M (MD)
Entity type:Individual
Prefix:DR
First Name:ODETTE
Middle Name:M
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1029 CALLE TEGUCIGALPA
Mailing Address - Street 2:LAS AMERICAS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921-2345
Mailing Address - Country:US
Mailing Address - Phone:787-754-8327
Mailing Address - Fax:
Practice Address - Street 1:LAUREL PLZ
Practice Address - Street 2:PEDIATRIC INMUNOLOGY CLINIC #100 LAUREL AVE
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956-3273
Practice Address - Country:US
Practice Address - Phone:787-786-6940
Practice Address - Fax:787-786-6940
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR7365208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics