Provider Demographics
NPI:1437101318
Name:GARCIA, LILIAN C (MD)
Entity type:Individual
Prefix:
First Name:LILIAN
Middle Name:C
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 NW 179TH AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-2807
Mailing Address - Country:US
Mailing Address - Phone:954-422-2828
Mailing Address - Fax:954-442-3366
Practice Address - Street 1:501 NW 179TH AVE STE 101
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-2807
Practice Address - Country:US
Practice Address - Phone:954-442-2828
Practice Address - Fax:954-442-3366
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL66052207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL373245200Medicaid
FLF91690Medicare UPIN
FL25197AMedicare PIN
FLAA412Medicare PIN