Provider Demographics
NPI:1578134029
Name:GARCIA, MARIBEL
Entity type:Individual
Prefix:
First Name:MARIBEL
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8648 NW 2ND TER STE 118
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-8309
Mailing Address - Country:US
Mailing Address - Phone:980-900-7876
Mailing Address - Fax:786-391-2357
Practice Address - Street 1:8648 NW 2ND TER STE 118
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-8309
Practice Address - Country:US
Practice Address - Phone:980-900-7876
Practice Address - Fax:786-391-2357
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-06
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCBHCMS.0102683104100000X
FLCBHCM.0104547104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker