Provider Demographics
NPI:1619838083
Name:BERMUDEZ GARCIA, SARAY LAZARA
Entity type:Individual
Prefix:
First Name:SARAY
Middle Name:LAZARA
Last Name:BERMUDEZ GARCIA
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 1:11441 LAKESIDE DR DORAL
Mailing Address - Street 2:APT 2404
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11441 LAKESIDE DR DORAL
Practice Address - Street 2:APT 2404
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33178
Practice Address - Country:US
Practice Address - Phone:786-229-1852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-24
Last Update Date:2025-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician