Provider Demographics
NPI:1124735436
Name:LACINA GARCIA, ESDENA (FNP/ PMHNP)
Entity type:Individual
Prefix:
First Name:ESDENA
Middle Name:
Last Name:LACINA GARCIA
Suffix:
Gender:
Credentials:FNP/ PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 W 66TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-6667
Mailing Address - Country:US
Mailing Address - Phone:305-303-7584
Mailing Address - Fax:
Practice Address - Street 1:12905 SW 42ND ST STE 103
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-2910
Practice Address - Country:US
Practice Address - Phone:305-824-0637
Practice Address - Fax:305-824-0628
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-04
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2024011618363LP0808X
FL11021647363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health