Provider Demographics
NPI:1083489553
Name:GARCIA ABSTENGO, DASIEL ULISES
Entity type:Individual
Prefix:
First Name:DASIEL
Middle Name:ULISES
Last Name:GARCIA ABSTENGO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8641 NW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6560
Mailing Address - Country:US
Mailing Address - Phone:786-838-9474
Mailing Address - Fax:
Practice Address - Street 1:18501 PINES BLVD STE 372
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-1414
Practice Address - Country:US
Practice Address - Phone:954-237-8545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-15
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty