Provider Demographics
NPI:1083354922
Name:GARCIA, MARYOLIS
Entity type:Individual
Prefix:
First Name:MARYOLIS
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 1:4471 NW 36TH ST STE 225
Mailing Address - Street 2:
Mailing Address - City:MIAMI SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33166-7256
Mailing Address - Country:US
Mailing Address - Phone:305-726-4388
Mailing Address - Fax:645-231-2068
Practice Address - Street 1:4471 NW 36TH ST STE 225
Practice Address - Street 2:
Practice Address - City:MIAMI SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33166-7256
Practice Address - Country:US
Practice Address - Phone:305-726-4388
Practice Address - Fax:645-231-2068
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-30
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician