Healthcare Provider Details

I. General information

NPI: 1962174540
Provider Name (Legal Business Name): GILENA GARCIA APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2021
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

645 W HALLANDALE BEACH BLVD STE 109
HALLANDALE BEACH FL
33009-5345
US

IV. Provider business mailing address

645 W HALLANDALE BEACH BLVD STE 109
HALLANDALE BEACH FL
33009-5345
US

V. Phone/Fax

Practice location:
  • Phone: 786-488-7870
  • Fax:
Mailing address:
  • Phone: 786-488-7870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11042807
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9540676
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: