Individual
DR. KEITH GARCIA DESOUSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 RIVERSIDE DR E STE 1100, BRADENTON, FL 34208-1022
(941) 867-2111
(941) 702-4204
Mailing address
270 E MAIN ST, BAY SHORE, NY 11706-8420
(631) 591-7470
(631) 591-7472
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
272403
NY
2084N0400X
Neurology Physician
ME112657
FL
2084V0102X
Vascular Neurology Physician
272403
NY
2084V0102X
Vascular Neurology Physician
ME112657
FL
2085N0700X
Neuroradiology Physician
272403
NY
2085N0700X
Neuroradiology Physician
Primary
ME112657
FL
Other
Enumeration date
08/24/2009
Last updated
03/08/2021
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