Provider Demographics
NPI:1194309682
Name:GARCIA, CIRA ELENA (RBT)
Entity type:Individual
Prefix:
First Name:CIRA
Middle Name:ELENA
Last Name:GARCIA
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:551 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-3633
Mailing Address - Country:US
Mailing Address - Phone:786-828-9765
Mailing Address - Fax:
Practice Address - Street 1:551 E 10TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-3633
Practice Address - Country:US
Practice Address - Phone:786-828-9765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-10
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-20-121700106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG620105645290OtherDL