Provider Demographics
NPI:1316464787
Name:GARCIA PEREZ, MARIA ESTHER
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ESTHER
Last Name:GARCIA PEREZ
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 1:9631 FONTAINEBLEAU BLVD APT 615
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-6862
Mailing Address - Country:US
Mailing Address - Phone:786-720-0850
Mailing Address - Fax:
Practice Address - Street 1:8050 NW 8TH ST APT 111
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-4036
Practice Address - Country:US
Practice Address - Phone:786-720-0850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-27
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-20-10776106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL109584100Medicaid