Provider Demographics
NPI:1386317907
Name:GARCIA CALDERIN, YAIMA
Entity type:Individual
Prefix:
First Name:YAIMA
Middle Name:
Last Name:GARCIA CALDERIN
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 1:1320 W 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-3406
Mailing Address - Country:US
Mailing Address - Phone:305-495-8572
Mailing Address - Fax:
Practice Address - Street 1:890 SW 2ND ST
Practice Address - Street 2:
Practice Address - City:FLORIDA CITY
Practice Address - State:FL
Practice Address - Zip Code:33034-4633
Practice Address - Country:US
Practice Address - Phone:305-495-8572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-29
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLBACB662538106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBACB662538OtherBEHAVIOR ANALYST CERTIFICATION BOARD
FL110652800Medicaid