Healthcare Provider Details

I. General information

NPI: 1710898119
Provider Name (Legal Business Name): GINA GARCIA PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 BOSTON AVE STE 206
ALTAMONTE SPRINGS FL
32701-4712
US

IV. Provider business mailing address

14520 HUNTCLIFF PARK WAY
ORLANDO FL
32824-5684
US

V. Phone/Fax

Practice location:
  • Phone: 407-967-7363
  • Fax:
Mailing address:
  • Phone: 407-967-7363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11050938
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11050938
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: