Provider Demographics
NPI:1063123370
Name:GARCIA, YASMELI
Entity type:Individual
Prefix:
First Name:YASMELI
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 1:3380 NW 7TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-4104
Mailing Address - Country:US
Mailing Address - Phone:786-656-3494
Mailing Address - Fax:305-777-7771
Practice Address - Street 1:3380 NW 7TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-4104
Practice Address - Country:US
Practice Address - Phone:305-501-0426
Practice Address - Fax:305-777-7121
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-07
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-144016106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician