Provider Demographics
NPI:1396138822
Name:GARRIGA HERNANDEZ, TAIMI CARIDAD
Entity type:Individual
Prefix:
First Name:TAIMI
Middle Name:CARIDAD
Last Name:GARRIGA HERNANDEZ
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 1:15852 SW 143RD PATH
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-6883
Mailing Address - Country:US
Mailing Address - Phone:786-367-2605
Mailing Address - Fax:
Practice Address - Street 1:15852 SW 143RD PATH
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-6883
Practice Address - Country:US
Practice Address - Phone:786-367-2605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-09
Last Update Date:2023-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
FLRBT1864145106S00000X
FL0-21-12408106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician