Provider Demographics
NPI:1063283448
Name:GARCIA, MILVIA ROXANA
Entity type:Individual
Prefix:MISS
First Name:MILVIA
Middle Name:ROXANA
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 1:10845 SW 112TH AVE APT 311
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-3255
Mailing Address - Country:US
Mailing Address - Phone:305-606-4043
Mailing Address - Fax:
Practice Address - Street 1:10200 NW 25TH ST STE A-108
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-5921
Practice Address - Country:US
Practice Address - Phone:786-717-5649
Practice Address - Fax:786-717-5754
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-12
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI57722355S0801X
FLSZ11927235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant